Epidural anesthesia, or peridural anesthesia, is the introduction of a local anesthetic into the epidural space, thereby blocking the nerve endings as they exit the spinal cord. Therefore, its effect is metameric, meaning it anesthetizes the body area corresponding to the nerves reached by the injected local anesthetic. It was discovered in 1921 by the Spaniard Fidel Pagés.
When the mother reaches 10 centimeters of dilation and the baby's head begins to press down, the pushing reflex is triggered. Previously, epidural anesthesia was administered in single, more concentrated doses, which posed a risk of numbness and motor paralysis that impaired the ability to push.
Currently, epidural anesthesia blocks pain but does not block movement, so the mother is able to feel contractions and the urge to push. The only thing eliminated is the pain from each contraction, but she may still feel pressure or muscle tension. Additionally, during labor, both mother and baby are monitored to determine when a contraction is coming. The anesthesiologist controls at all times the amount and type of medication administered. In the initial stage, the anesthesiologist’s goal is to relieve uterine contractions; later, the goal is to relieve pain in the vagina and perineum when they are dilated and ready for the baby’s passage. If movement begins to be blocked, or there is weakness in the legs or any other complication, the anesthesiologist will reduce the medication amount or change it, and may even administer another drug through the epidural catheter.
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