However, before giving the medicine, anesthesiologist carefully examines the condition of the pregnant woman to whom anesthesia is to be given. Epidural anesthesia during labor and normal delivery does not cause unconsciousness; thus, patients do not lose their psychological alertness (Halpern and Douglas 2008).
According to (Orebaugh 2011), epidural anesthesia is commonly administered by injecting the medicine in the lumbar region of the back, specifically in the epidural region. The detailed procedure regarding the administration of epidural anesthesia has already been discussed in the previous section of the paper. However, the anesthetic drug injected in the epidural space interrupts the passage of nerve impulses that originate in reproductive organs and travel through nerves to lower spine and then to brain. This hinders the feeling of sensation/pain that is produced in the lower parts of the body.
The degree of insensitivity induced depends on few factors that include the quantity and the nature of medicine that has been injected. Large quantities will lead to greater loss of sensation for longer time. Moreover, these medicines may be injected together with other types of drugs that assist in obtaining required and desirable effects. Nevertheless, the induced numbness is temporary and the region subjected to it regains its ability to feel as soon as the effect of anesthesia fades away (Orebaugh 2011). Studies by Akbas and Akcan (2011) highlight that epidural anesthesia induce numbness not only in the lower section of the body. At instances, it may affect the upper parts such as chest and abdominal cavities in order to relieve pain.
According to Helpern and Douglas (2008), the technique of using anesthetics and analgesics in the obstetric practice began during 1847 by James Young Simpson. Many forms of anesthesia had been utilized until the epidural anesthesia came into practice. Middleton (2006) notifies that epidural anesthesia particularly gained attention when a tube like instrument catheter was used along with a needle to allow the insertion of anesthetic into the epidural space even after the removal of needle from the body.
Halpern and Douglas (2008) discuss that the field of anesthesia has gained colossal attention of the people and recently many are pursuing it as their career for which they take extensive training to become experts. Coupled to this, midwifes are also trained in this respect; therefore, this technique is now available in larger hospitals as well as in smaller obstetric clinics and is becoming more contentious for its usage in normal labor and delivery.
Using different forms of anesthesia including epidural in normal delivery have remained controversial, as all pose threats to the health of mother and baby. Numerous debates have been witnessed because despite of the significant role of epidural in pain relief, much severe risks are also connected to it, which raise concerns for professionals and patients. This aspect will be dealt with in the following discussion.
This section of the paper is based on the discussion of benefits and risks associated with epidural anesthesia in normal vaginal delivery. Moreover, arguments by different experts and authors together with personal stand regarding the controversy have been presented.
Impact of Epidural Anesthesia on the Health/Medical State of Mother
Akbas and Akcan (2011) discuss that epidural was initially used to relieve pain for those pregnant ladies who faced complications during normal delivery and had to undergo cesarean as an alternative. But nowadays the purpose has transformed and epidural anesthesia has started to be commonly used in normal vaginal delivery. However, in case of cesarean birth, severe pain experienced by the mothers can be assuaged by using this technique. Moreover, epidural in cesarean section is preferred over general anesthesia for an apparent reason that epidural does not cause the patient to become unconscious. As a result, mother can enjoy the precious moment of the birth of her child and can nurture the baby immediately after delivery.
On the contrary, (Baxley and Cline 2008) argue that in case of utilizing epidural in normal delivery, there exist potential dangers that can contribute largely in complicating a normal delivery case. This has increased the concern because a woman who can have normal delivery should go on with this ordeal without external interventions in the natural process of childbirth. My stand regarding this issue is that I disagree with the usage...
Additionally, medical principles clearly teach that no such measures should be used that pose threat to the life of patients (mothers in this case).
Some schools of thought discuss the health aspect of mothers and believe that epidural anesthesia assist in comforting the patients by reducing their labor pain, as they numb the nerves that carry messages for making the pain felt so it is beneficial (Green 2011). However, (Baxley and Cline 2008, Murray and Huelsmann 2009) argue that this is not always true because cases have been witnessed where labor contractions grew weaker under the effect of epidural anesthetics and have developed complications, which then required the progression of delivery by either cesarean or other techniques. Furthermore, pelvic muscles are adversely affected that cause restrictions of movement in mothers who then face difficulties during childbirth, as they cannot make appropriate movements to advance the procedure. Additionally, when pelvic muscles do not function properly, it creates problems for baby to be moved out of the womb, which necessitates the employment of other methods. These are very painful, as few entail the need for stitches that takes several days to heal.
I deem that when normal delivery is possible without administering epidural anesthetics then it should be avoided in order to prevent worsening of the state of mother and fetus. Moreover, it is useless to exercise a technique of pain reduction that, at instances, itself lead to application of more pain inflicting processes for mothers.
Moving onwards, experts discuss the medical aspect related to mothers who claim that epidural anesthesia is effective because the injected medicines do not make the mother feel lethargic and sleepy. Furthermore, she can retain her consciousness and remain relaxed till the time of delivery (Akbas and Akcan 2011, Green 2011). Conversely, (Orshan 2008) disagrees and states that the mother cannot get down from her bed when given epidural and is required to remain only in few particular positions throughout until the catheter is removed from her back.
I support the latter argument because the purpose of epidural is to provide relieve to mothers who are subjected to utter pain but this argument draws the attention to the fact that this practice is contributing to the discomfort of mothers (related to medical aspect). Thus, I disagree to the usage of epidural in normal delivery because it has potential capability to make that normal process complex.
A rare but complex risk of epidural associated to mother's health condition is that while administering the anesthetic, the needle may get inserted into nearby blood vessel, which causes bleeding. Moreover, wrong site of insertion may beget to leakage of cerebro-spinal fluid which causes prolong headaches (Baxley and Cline 2008). My point-of-view related to this is that epidural disturbs the natural bond shared by mother and her baby, as headaches hinder the mother-child interaction after the birth. Therefore, I totally condemn the administration of epidural in normal delivery.
One more major risk related to medical/health aspect of mothers as explained by Epstein (2013) is that epidural may lead to neurological destruction in mothers as a result of neural puncture while injecting the medicine. Similarly, several forms of infections due to using infectious injections can develop in mothers including deadly forms of meningitis. Many practitioners are themselves unaware of these risks and even if they do know, they hesitate in telling this to mothers. I believe that mothers should be made aware of the risks associated with epidural beforehand, who will then certainly disagree with being administered with it as I do.
Where many research works favor the use of epidural; Wilson, Macarthur, and Shennan (2009:97-103) argue over another health risk of epidural for mothers which states that the medicine injected in epidural space may also anesthetize the bladder. This is explained by the anatomy of human body which illustrates the close positions of uterus and bladder. Numbing of bladder leads to difficulty in excreting urine (due to loss of sensation) which begets to connecting a catheter to the bladder. My viewpoint regarding this argument is that placement of catheter makes the patient uncomfortable and may be a source of awkwardness. Furthermore, epidural can turn a blissful time (as would have been the case in normal delivery without epidural) into a miserable time.
Another medical aspect of epidural is that it lowers the blood pressure and is beneficial for those mothers that suffer from hypertension (Wilson, Macarthur, and Shennan 2009:97-103); however, there remains a concern that not all mothers face this enormity. Consequently,…
In addition, it is not apparent whether the injections may relieve pain, but for those without surgical lesions the injections may delay requisite surgery and result to permanent neurological deficits. It is evident that some risks associated with infectious epidural steroid injections result to fatal meningitis, but those performing epidural do not make pregnant women opting for epidural aware. I feel that such risks are matters of life and
In year 1799 anesthetic properties of Nitric Oxide were discovered by Humphery Davy (1778-1829) he advised that the by using nitric oxide, pain and shock of the surgical procedure can be negated. Third person who continue with Morton and Wells philosophy was Charles T. Jackson. The Fourth man who contributed to anesthetics was Thomas Mortan (Blatner, 2009). In the year 1848 James Simpson used chloroform in obstetric surgery, he
(Stremler, Halpern, Weston, Yee & Hodnett, 2009, p. 391). (De Sevo, M. & Semeraro, 2010, p. 11) the implications being that the overmedicalization of the labor and delivery process has been well intrenchend in nursing culture and may influence increased rather than decreased medical intervention use for women, even when they would not necessarily have needed it. The challenge to nursing is then to begin to support a reduction
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that
elective or emergency childbirth, a choice between general and local anesthesia is often called for. Cognizing the surroundings helps the birthing process. Therefore, a local anesthetic administered via an intrathecal spinal injection or through a catheter in the epidural space will prove an advantage. Ratcliffe and Evans at John Radcliffe Hospital in Oxford, England attempted tested this advantage on more than 90 elective Cesarean parturients. (Ratcliffe & Evans, 1993)
For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings. The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane