Epidural Live Q&A

If I’ve had a failed epidural before, what are the chances of it happening again?

It depends on why it failed last time. Usually, epidurals fail due to the insertion of the needle. Sometimes, it isn’t in properly, has fallen out or is off to one side. We are aiming for the middle of the spine, but occasionally there can be reasons for it to not work. If you have hypermobility & local anaesthetic doesn’t work, its unlikely epidurals will work for you. It could be due to spinal surgery or  the epidural might have been put in too late and you deliver before the epidural kicks in so ask for it early.

What is the difference between a spinal and an epidural?

Both are used to take away pain. Epidural is used during labour. It is an anaesthetic put in plastic tube and it runs through a pump which can be topped up to take the pain away as a continuous process. The spinal is a much smaller needle and it is just a one shot injection. It goes a little further into the fluid around your spine and works very quickly. We can repeat a spinal but is not recommended.

I am due to be induced due to high blood pressure. I understand it might be recommended to have an epidural in labour to help control it, would you agree this is a good idea?

A beneficial side effect of an epidural is that it lowers blood pressure. There’s other factors to consider, such as if you’ve had kids previously without an epidural, meaning you might not need one. It is not necessary to have one due to high blood pressure.

How do you approach patients who have severe scoliosis? What are your recommendations on epidurals?

If you have scoliosis, you have a twist in your spine. Most people have very minor scoliosis, but if it is severe it is usually in the top half of the spine, which doesn’t cause us any problems as we are injecting in the lower spine. Most people with scoliosis will be spoken to in the moment and we will find a plan that suits you. If you have had spinal surgery and have spinal rods, an epidural may not work for you, as the scar tissue doesn’t allow the drugs to spread. There is also a higher risk of infection due to the metal work.

Is it usual to have a mobile epidural?

The nerves that are smaller and easier to block with the anaesthetic will be blocked quicker, but the ones that you use to move your legs are thicker and more insulated. The plan of the epidural is to give you pain relief – we ask you not to walk around for your own safety and comfort. However, you can sit upright in the beds with your legs down. If you have your epidural early, or if it running for more than 4 or 5 hours you may start to feel the nerves being blocked in your legs and there is no way to stop that from happening other than taking a break from the anaesthetic.

Can I request an epidural when I am admitted? Will there be resistance or judgement from the midwives?

There will not be any judgement from our midwives at MKUH. There are some circumstances where it may be appropriate resistance – if they think it is too early they might ask you to wait for later, closer to your labour. If you are fully dilated they may also say it is not recommended to get an epidural as there is not enough time between getting it and the labour itself – you will not receive any benefit from it.

Under what circumstances would you recommend an epidural over other forms of pain relief?

It depends on if you’ve had a baby before and experienced the pain associated with it. It also depends on your pain threshold and your hormone drip too. You can request epidural, as there are always anaesthetists on labour wards. The alternative pain relief we offer do take away pain, but a good working epidural is the most effective.

Is there anything that can take place if the epidural does not work or only numbs part of the body?

Yes, sometimes it is one sided, so we can try turning you on the side it is not working to spread the anaesthetic. If you fall asleep with your epidural and forget to press the button for a while or it is not strong enough, we can up your dosage. Occasionally they don’t work or fall out, so we can offer to do another one for you.

Will an epidural have an effect on my baby? Am I more likely to have complications with my birth if I have an epidural?

The drug we give will not touch the placenta. But it may restrict the blood flow to it. The natural effects of the anaesthetic can drop your blood pressure; but we monitor the baby’s heart rate and we will give you extra fluids and medication for this.

Last Modified: 9:21am 20/08/2020