What is an epidural and how does it work?
An epidural is where painkilling drugs are injected into your lower back, through a hollow needle between the small bones in your spine. A fine tube is then passed through the needle. Once the tube is in place, the needle is removed and the tube is taped up your back and over your shoulder. This is called a regional anaesthetic which means the drugs are injected around the nerves and then carry signals around your body to the spot that feels pain while in labour. The anaesthetic deadens the nerves which are carrying pain signals. Most hospitals use low-dose epidurals containing a mixture of painkilling drugs. The epidural makes your belly feel numb, giving you very effective pain relief.
An epidural is given in several ways:
Injection with top-ups: Your anaesthetist will inject the painkillers into the tube. If it is working well, you should no longer be able to feel your contractions. As the epidural begins to wear off, you can have top-ups which last between one and two hours.
Continuous infusion: Your anaesthetist will set up an epidural tube. The other end of the tube is attached to a pump, which feeds painkillers into your back continuously. If you need to, you can have stronger top-up doses of local anaesthetic as well. •
Combined spinal epidural (CSE): You will be given an injection which contains a low dose of painkillers (a mini spinal), which works quicker than just having the epidural on its own. At the same time, the anaesthetist will insert a tube without passing anything down the tube just yet. When the effect of the mini-spinal injection starts to wear off, your anaesthetist will pass the second painkiller mixture through the tube to give you further pain relief. Who would benefit?
An epidural can be given at any stage of labour, but most women choose to have it when their contractions start getting strong. This is often when the cervix has dilated by about 5-6cm. An epidural will also be...
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