Epidural question

[Kim44]

I had a baby last year. I was induced, laboured for 12 hours then got my epi. I didn't progress and had a c/s 8 hours later.

I heard the Doc say that he was going to top up my epi for the surgery, and then my arms went numb, and stayed numb for a little over an hour.

I've mentioned it to several friends who have had sections and they haven't experienced this numbness in their arms. I don't understand how this happened, without having respiratory problems.

Thanks for your expertise!

[nilepoc]

the medicine injected into an epidural is injected into a closed space. The area of influence of an epidural is determined by the spread of the drug in that confined space. Every patients epidural space is a different size. So in one patient a dose of drug will get the nerve roots at the t4 level, where in another that same dose may get the nerve roots at the t2 level.

My question to you, is how tall are you? Shorter people have smaller epidural spaces. So the medicine may spread higher in the space. What you experienced was the blockade of higher than usual spinal rooots.

I hope this answered your question.

for reference

C 3,4,5 = Diaphragm

C 6 = Bicep flexion

C 7 = Tricept extension

C 8 = Finger Abduction

T 1 = Abduct fingers against pressure

[Kim44]

Thank you for the response.

I am 5'1", that explains it I guess.

I still don't understand why I could breathe without difficulty though. I thought that if an epidural went too high, it would affect the diaphragm.

Again, that you.

[charles-thor]

The diaphragm is innervated by the phrenic nerve (C3-5), so it would have to ascend the lumbar and thoracic areas before it reached the cervical spine. In patients with an underlying respiratory pathology, who rely on their accessory muscles for adequate ventilation, a mid to high thoracic block could become problematic and require some assistance. I presume that you are health, and this is why you didn't have difficulty breathing.

[Brenna's Dad]

Finger sensory is C8 for the pinky and C6 for the thumb. Traditionally, it has been thought that motor blockade is at least two levels lower than the blocked sensory dematome. That takes you to at least a T2 motor blockade, meaning lots of intercostal motor blockade, but not even close to the diaphragm. Did you have any subjective sensation of difficulty breathing, or the inability to feel yourself breathe?

[Kim44]

I had no respiratory symptoms at all. I had no feeling in my fingers, I don't remember if I had feeling in my thumbs.

Most importantly I guess, I had no feeling in my uterus!

Thanks for the info, what an informed group you are. :)