Epidural / Spinal Block (confused)

[j0yegan]

I don't work in L&D. I'm new to postpartum and I just want to be able to fully understand.

Most lady partsl deliveries consist of using epidurals. What is the exact medication that is used for that? Morphine??

Most C-sections consist of Duramorph (morphine sulfate)... is that given epidurally or spinal block most commonly?

Because when I get report, I find myself a little confused when they say "S/P epidural" or "S/P Duramorph". The Duramorph can be given epidurally, correct? I know spinal headaches can be from spinal blocks... AND epidurals or just spinal blocks?

Sorry if I'm confusing you from my own confusion. lol.

[melmarie23, MSN, RN]

Most of our epidurals are fentanyl and bupivacaine.

[klone, MSN, RN]

There are two types of lumbar anesthesias - spinals and epidurals (also known as CLEs - continuous lumbar epidurals). A CLE is given while in labor, and provides continuous medicine through the epidural catheter to keep the dermatomes numb until after she delivers and the epidural pump is shut off. The medication usually consists of of a -caine of some sort, like bupivicaine, and Fentanyl. A spinal usually consists of the same medications, but is an in-an-out injection into the spinal space, rather than threading in a catheter that stays in teh back and giving a continuous infusion, so it's shorter action (less than an hour). It is generally used for C/S and sometimes I've seen it used when the woman is really really close to delivery but wants an epidural. For C/S, the anesthesiologist may also place duramorph into the spinal, which is long acting morphine, which gives 12-24 hours of morphine pain relief, and is WONDERFUL.

Also, many anesthesiologists, when administering an epidural, will give a spinal dose (which is fast acting and results in almost immediate pain relief), and then the patient will get the epidural dose through the pump. What that means is that both an epidural and a spinal both have the same risk of a woman developing a spinal headache.

HOpe this helps!

[SmilingBluEyes]

Our anesthesia providers did a quick intrathecal-epidural, by giving Fentanyl/ Bupivicaine in the intrathecal space, then going deeper in the epidural space, with more medications. The relief they felt was so quick,yet complete.

[j0yegan]

Thanks people! :)