To whom is epidural analgesia not applied for normal delivery?
1) None of the patients who did not accept the method
2) Patients with a blood disease related to coagulation
3) Patients with skin infection in the area where the catheter will be inserted
4) Patients with very low blood pressure
5) It is not applied to expectant mothers who have increased intracranial pressure for any reason and have neurological diseases.
What complications can occur in patients who receive epidural analgesia?
Sometimes extreme drops in blood pressure can occur. For this, at least 500 ml of serum is given to the patient before the procedure. Since the patient’s blood pressure will be checked frequently, drugs that increase blood pressure are administered when blood pressure drops.
Headache ; It is the most common complication after epidural and spinal procedures. Its incidence varies between 0.2-20%. However, we believe that this rate has decreased even more in recent years, thanks to the quality of our needles and the experience of our doctors. Normally, the ligaments of the spine are loose and the tissue is edematous. The epidural space becomes difficult to detect and negative pressure is lost during uterine contractions. The risk of dural puncture (puncture) increases. Headache occurs as a result of leakage of CSF (cerebrospinal fluid) after dural puncture. By standing up; Headache increases with coughing. It may be accompanied by stiffness in the neck, nausea, vomiting, sensitivity to light, tinnitus, loss of appetite. Headache treatment; bed rest, analgesic, sedative, antiemetic, caffeine (not given to those with epilepsy, preeclampsia and hypertension). After 5 to 7 days, 90% improvement is seen with this treatment. Most of them go away on their own without treatment. In some very rare cases that do not go away despite treatment, a blood patch is done. 10-20 ml of blood taken sterile (from the person’s self) to the perforation area is injected into the epidural area. He usually responds well and immediately the patient says ‘I have a light in my eyes’. However, this procedure has its own risks. Like a new dural puncture, hematoma, risk of infection, back pain.
Catheter rupture, spinal cord injury, damage to nerve roots, tremor, difficulty in urination, back pain, neurological complications, epidural hematoma can be seen very rarely.
