May cause shivering .
May increase need for vacuum/forceps extraction .
Increased incidence of C Section (if given too soon and with first baby) .
Block may be 'one-sided' or blotchy .
May cause postpartum urinary retention .
May cause an elevation in mother's temperature .
May hamper 'push-ability' .
May cause mild itching of face, neck and thorax .
May delay babies early 'latch-on' ability to breast feed. .
May cause septic meningitis. .
Contraindications for having an Epidural.
Bleeding disorder or on anticoagulants .
Infection in area of Epidural Injection .
Thrombocytopenia .
Patient refusal .
Spinal Anaesthesia.
Spinal anaesthesia is induced by injecting small amounts of local anaesthetic into the cerebro-spinal fluid (CSF). The injection is usually made in the lumbar spine below the level at which the spinal cord ends (L2). Spinal anaesthesia is easy to perform and has the potential to provide excellent operating conditions for surgery below the umbilicus. .
In obstetrics, it is ideal for manual removal of a retained placenta (provided there is no hypovolaemia). There are definite advantages for both mother and baby in using spinal anaesthesia for caesarean section. .
The Advantages of Spinal Anaesthesia.
Cost. (If the patient has to pay) Anaesthetic drugs and gases are costly and the latter often difficult to transport. The costs associated with spinal anaesthesia are minimal.
Patient satisfaction. If a spinal anaesthetic and the ensuing surgery are performed skilfully, the majority of patients are very happy with the technique and appreciate the rapid recovery and absence of side effects.
Respiratory disease. Spinal anaesthesia produces few adverse effects on the respiratory system as long as unduly high blocks are avoided.
Patent airway. As control of the airway is not compromised, there is a reduced risk of airway obstruction or the aspiration of gastric contents. This advantage may be lost if too much sedation is given.