Recently rolled out adventure «The Lone Ranger», one of the main roles in which performed everyone’s favorite Johnny Depp. Almost all the stunts in this film, as in many others, the actor acted on their own, several times unsuccessfully fell and severely injured his back. At the end of the shooting pain in the spine it was unbearable, and Depp appears in the frame only after the epidural.
What is epidural anesthesia
The term «anesthesia» is made up of particles of negative words and AN aisthesis, that is, «feeling» and literally translates from Greek as «insensitivity.»
And the adjective «epidural» includes the prefix «epi» meaning «above», and the root of the derivative of the Latin dur dura mater — the dura mater. It is a layer of connective tissue that surrounds the spinal cord and contains the nerve roots, conducting pain impulses. In 1901, German physician Kornig first proposed a method to block the sensitivity of these roots by administering pain medication at the epi-dural space, ie in the area between the dura and the spinal canal.
HOW DOES THIS HAPPEN
The anesthesiologist makes sure the movement of the puncture in the right segment of the spine — for example, in the lumbar, if you want to numb the lower part of the body, for example, at birth or caesarean section. Penetration into the epidural space occurs via a special long and necessarily sterile needle with stylet, which connects the catheter. Through it, in the body and enters the anesthetic. After 15-20 minutes the person ceases to feel pain.
But it may come to replace other highly unusual and unpleasant sensations — such as numbness and heaviness in the limbs, muscle tremors, ie jitter. Often there are slight dizziness, nausea, weakness, due to a slight drop in blood pressure, which is natural in the epi-dural anesthesia.
Such reactions should not be afraid, they disappear as soon as the end action of the drug. However, all his feelings during and after anesthesia is necessary to articulate the anesthetist, who must be around and to control the situation.
After all, despite the fact that epidural anesthesia is one of the safest types of anesthesia, there may be complications.
Rarely, but METKO
Research shows that complications of epidurals occur infrequently in 0.02% of cases, but know about them and be sure to doctors and patients.
At the time of the manipulation can develop an allergic reaction to the anesthetic, blood pressure plummet. For long-term effects include brain and spinal pain that may last for several months. The most severe complications after the intervention are occurring both during anesthesia and after the paralysis of the limbs, bruising, bleeding in the spinal cord. Alas, most of the failures in the conduct of such pain relief due to the negligence, incompetence and inexperience of the doctors who are doing wrong himself puncture, incorrectly calculated the dose and concentration of anesthetic do not take into account contraindications, and they are many!
It is strictly forbidden to do epidural people with severe deformities or inflammatory get sick of the spine. Also it is contraindicated in traumatic shock, intolerance to anesthetics, brain tumor, intestinal obstruction, peritonitis. With great care to hold similar analgesia for obesity second and third degree, in old age, when the marked decrease in extensibility and volume of the epidural space. For a long time it was considered a relative contraindication persistent hypotension. Now adjust the echo problem learned with the necessary dose of saline, and then the pressure is normal. In general, doctors are unanimous in saying that if there are no contraindications, of all anesthetics epidural has the most advantages and is indispensable in addressing many health problems.
This type of anesthesia is often used as a supplement to the general, reducing the dose, as well as blood loss. The combination of these types of anesthesia and helps reduce the risk of complications in the cardiovascular and respiratory systems. Also epidural perform the operations on the organs of the reproductive system, and even when abdominonlastike and liposuction. Often used this kind of orthopedic anesthesia and use it to fix fractures. It was found that patients who underwent prosthesis replacement under epidural anesthesia, then less often develop complications such as deep vein thrombosis. Studies show that such anesthesia, made after the amputation, does not develop unpleasant phantom sensations. Often it is needed as a kind of symptomatic treatment of back pain. But the most widely used of course she got in obstetrics.
In the West for several decades, many women give birth under the action of epidural anesthesia. Mother of many children Victoria Beckham admitted that would not would start as kids, if she does not anesthetized childbirth. In Russia, this fashion has come relatively recently and also caused a flurry of enthusiasm. Indeed, epidural anesthesia allows women to feel less pain during labor, to maintain awareness and actively participate in childbirth, her nighttime and the uterus is well supplied with blood, no anesthetic acts directly on the fruit does not fall into the baby’s blood. However, there are studies showing that anesthesia can be an obstacle for deeper psychological interaction between mother and child. This is one reason, but that natural childbirth has chosen the Duchess of Cambridge Kate Middleton.
Did the risk?
According to most doctors, epidural necessarily shown in multiple pregnancies, premature and rapid delivery, caesarean section. In all other cases it is possible and even necessary to endure the pain in order not to disturb the natural balance of this difficult but very happy moment in the life of any woman.
Recently, British researchers analyzed existing in the world of research on epidural anesthesia during childbirth. It turned out that every fifth woman and her baby experience side effects after this anesthesia. Since birth, accompanied by epidural anesthesia, often weaken the fight, often required childbirth. It can be stimulating drugs, vacuum extractor or forceps. We prove that stimulants act on the nervous system of the newborn that later manifested hyperexcitability.
A supporting machine tools — ego is the additional risk of birth trauma. Also, this type of anesthesia helps reduce blood pressure. This can lead to disruption of blood flow to the placenta and cause anoxia in the fetus, which will necessarily affect the development of the white brain matter. The negative effects are manifested in children of two years, as a rule, speech disorder, conduct disorder such as autism. In the postpartum period in women receiving epidural anesthesia, is often observed violation of urination, numbness in the legs, back pain, headache, irritability.
So, it is obvious that an epidural — one of the most effective and safest ways of anesthesia that exist today.
In general, the risk of complications is minimized, as opposed to, for example, general anesthesia, but still exists. The area of the spinal cord — a very sensitive area, so sometimes a reaction to the introduction of anesthetics is unpredictable and if possible to do without anesthesia (eg, labor), it is better to give it up. If there is no escape or do not want to endure the pain, you should find a good doctor and perform all of its recommendations.