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 distribution is metameric, meaning that the area of the body corresponding to the nerves reached by the injected local anesthetic will be anesthetized. It was discovered in 1921 by the Spanish doctor Fidel Pagés.
When the mother reaches a dilation of 10 centimeters 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 carried a risk of numbness and motor paralysis that impaired the ability to push.
Currently, epidural anesthesia blocks the pain but does not block movement, so the mother is able to feel the contractions and the desire to push. The only thing eliminated is the pain from each contraction, but she may feel pressure or muscle tension.
Additionally, during labor, both mother and baby are monitored, and the timing of contractions can be anticipated. The anesthesiologist continuously controls the amount and type of medication administered. In the first stage, the 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 to pass through. If movement begins to be blocked, weakness in the legs is felt, or any other complication arises, the anesthesiologist will reduce the dosage or change the medication, and can even administer another medication through the epidural catheter.
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