OB Nursing

I was reading my OB book but I need more info.

1. When an epidural is needed, lidocaine and epineprhine are given as a test dose to make sure the puncture is not in the intravascular or subarachnoid space. What would happen when it is in the inravascular or subarachnoid??? What would both of these drugs do when they are in the intravascular or subarachnoid???

2. Why do they wait to place an epidural in a primipara woman who is 5-6cm dilated vs. a multi para woman who is 3-4cm dilated??? Wouldn't the dilatation for primipara woman be smaller than the multipara woman because multipara women have given birth more than once and they would dilate much more than the primipara???

I can answer question 2.

Epidural shouldn't be placed in a prima any earlier than that because it could slow labor, especially since they don't have a history to go by.

In a multip 'most' times, once they are in labor they will continue in labor. So pain relief will help progress their labor.

The answer to #1 is that it would make the heart race if it was injected intravascularly. If it is in the correct place, nothing should happen.