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Epidural

The term epidural is often used as a short form for 'epidural anesthesia'. As a first step before administration of an epidural, an IV is given with relaxing medications. The next step is that the physician numbs a small area of the skin with numbing medicine. The physician then directs a small needle using x ray guidance into the epidural space. A small amount of contrast dye is injected to insure that the needle is properly positioned into the epidural space. Finally, a small mixture of numbing medicine or anesthetic and anti-inflammatory injection is injected.


Risk of epidural during childbirth

  • A mother with low platelet count may make the placement of an epidural more risky.
  • Sometimes due to weight problems, it becomes impossible for an anesthetist to find the epidural space.
  • Epidurals cannot be administered if the mother is bleeding heavily or suffering from shock.
  • It is observed that sometimes epidurals can lead to fetal distress and fetal malposition.
  • Increased risk of forceps or vacuum extension, episiotomy and increased risk in cesarean section is observed because of epidural use.
  • A study of breast feeding mothers conducted in 2006 reveals that mothers who received an epidural were more likely to experience problems in breast feeding during the first few days after delivery.

Epidural Hematomae

Epidural hematoma, also referred to, as extradural hematoma is a collection of blood between the brain's tough outer membrane called the dura mater and the skull. This condition is very hazardous as the bleeding builds up pressure in the intracranial space thereby constricting the brain tissue and therefore requires immediate monitoring by physicians. Common reasons for epidural hematoma:


  • A blow to head due to a road accident.
  • Falling from a height and thus sustaining head injury.
  • Any type of head injury that can lead to a skull fracture.

Symptoms of epidural hematoma range from severe headache and giddiness to increased size of one of the pupils of the eye. Rarely does a patient suffer seizures. With severe cases of epidural hematoma or as time elapses since the injury lethargy, unconsciousness, unable to arouse from deep sleep (at times lead the patient to coma) can occur. After studying the CT scan and depending on the extent of the damage caused, a neurosurgeon will recommend surgery.


Neuroplasty

Neuroplasty is reconstructive surgery for damaged nerves. This plastic repair of severed peripheral nerves is now commonly done on scar formations in the epidural area. This could have happened due to earlier surgery or inflammation. Epidural neuroplasty is done through x-ray guidance and is usually an outpatient procedure. It is necessary to take precautions against any kind of drug related complications.

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Collection of Pages - Last revised Date: December 12, 2017