The Power of Epidurals

Kind attn : Mr. Divesh Nath
For WE Health, Beauty & Sex Special

Name: Sudha Hariharan

A/c No : 424

Date: Feb 18, 2010



GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.

“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.



“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.

“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.

Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)