Spinal block and Epi?

[Caz1971]

Are these two the same thing??. Going today to discuss with anasthesiast if Im for a spinal or general. Will go with the spinal..

Caz

[agadoo]

you can have a general?!

[Caz1971]

Nah - I dont want to be asleep..Ive had the epi last time with my c-section so I know what it feels like.

[~mamaspice~]

Apparently the spinal block is a one off injection of anaesthetic in the spine which will numb you for a few hours then it will wear off gradually, whereas the epidural is where the anaesthetic is fed intraveniously into the spine and it stops when they turn it off and pull the tube out. They both serve the same purpose though.

Hope this makes sense

[~Kim~]

THey both go in through the same insertion point but are different drugs.
I had an epi for some hours (while nothing happened) and then they gave me a block for my c section.
The spinal block paralyses as well.

[Beach Mama]

I had an epidural during the labour, and my legs could sort of move, but only just and thought they would just up the dosage or something when they told me I had to have a caeser but they took the epi out (its a catheter tube that stays in your back) and then gave me the spinal block which paralyses from chest down basically and it a single injection.
It started slightly wearing off while I was in recovery and then about 1-2 hours later I was able to move my legs again (gently under the covers!)
Good luck!

[Mother Goose]

The main difference between the spinal and epidural is the space inwhich it is inserted. They both enter the spine but it is the "cavity" that the drug is administered into which makes the difference. Usually they use the same drug for both but that depends on the anethetist.
Most anethetists and Ob's will only use a GA in an absolute life and death emergency - it is not the norm for a c-sect. There are, however, exceptions to the rule.

HTH

MG

[~mamaspice~]

MG, just out of curiosity, is the spinal space lower than the epidural space? When I had my caesar the anaesthetist tried to get the epidural in 4 times and kept hitting bone. On the fifth go he tried a lower space and he got it in but I didn't go numb (only one leg did) so ended up needing a general So I'm just wondering if it might have been the spinal space he tried on the last time?

[AnyDream]

C'smumma, the anaesthetist explained to me that when they try to do either a spinal or an epidural, there are a small number of ppl whose back joints are shaped a bit differently (normal for them of course) or sometimes there's this membrane that's in a different place to most ppl, which can make the epidural uneffective, usually it only numbs one side of the body.

Also, sometimes because the spinal is a single dose medication, if the dose is not quite right (either too much or too little) they can't re-do it and you will then need a general. I understand that's pretty rare.

Agadoo, you can have a CS under a general but it's generally considered not the best scenario because women struggle to cope with the birth transition, they wake up and there's this baby there. It's also harder to give mum and baby time together immediately after birth because it's so much more medicalised. The general surgical risk factors are higher under a GA too. However I believe that there may be some circumstances where a Dr would agree to do the CS under general as that was one of the options presented to me on the basis of my previous birth trauma.

[butterfly*kisses]

I have had 3 C-sects - 1. Epi 2. Spinal 3. Spinal with walking Epi

I have to say that the last one was the best. They used the Spinal for the actual procedure - but the anaesthetist inserted a 'walking' Epi at the same time for pain relief afterwards.

Something to be aware of - the Spinal uses morphine - and I didn't know that. I was violently ill afterwards - which is really not a nice thing straight after a C-section.

[~mamaspice~]

Hi Marydean, thanks for the info. I have since had some xrays of my spine and I have something called Hyperlordosis which basically means that my vertabrae curve on a different angle. Apparently if the anaesthetist looks at my xrays he should know the angle he needs to put the epi in next time. That;'s interresting about the not going numb factor. it doesn't look too good for me does it Although I'm hoping there is no caesarean with #2 as I don't want to risk having a general again. You are sooo right about how having a general affects the mum. I felt completely robbed of a birth experience and I woke up out of the anaesthetic crying. Bub was placed on my chest and it was all very surreal. I grieved that I missed the first 1.5 hours of her life. i ended up having B/feeding problems and I got PND. I would seriously NOT recommend a General if you could avoid it.

[AnyDream]

s C'smumma - I hope you have had a chance to debrief and are starting to heal that grief. I hope you have a much better birthing experience next time round, I found my second birth completely healed the trauma from the first. The anaesthetist did say that if a person had ever had a problem with any anaesthetic they would look at the notes and gather all the info very carefully so they could get it right the next time, so it might be worth making sure the notes/xray are in your file. *touchwood* that they won't need it, and you've certainly come to the right place to get all the info and support you need for a VBAC. Good luck

[Mother Goose]

HI Charlie'smumma,

I also have a "difficult" back for inserting an epi - it took over an hour to get mine in with DD and then I still felt contracting in the lower left quadrant of my belly so had to lay on one side to get it to "run".
They can insert the spinal and epi through the exact same spot on the back - it is just how far the needle is pushed in. If you think back to high school science and how they taught you about the different layers of the skin, it is the same principle. The only thing is, with the spinal, they can't insert it above a certain physcial space because of the risks involved with it affecting breathing etc.

If you have the xray and the anethetist works with it, I don't see any reason why they won't be able to give you effective analgesia for a c-sect without having to resort to a GA.

HTH

MG

[~mamaspice~]

Hi MG, thanks for the info.
So if they got the epi in and I only started to go numb down one side I could possibly get it to work properly if I lay on my side for a while? That's good to know, thanks I wonder why they didn't get me to try that when I had my CS. They just all of a sudden told me that they had to give me a general and wacked the mask on my face

[Mother Goose]

I was only able to lay on one side and let it "work" because I wasn't scheduled for a section at that point. I was induced and had the epidural inserted about 2pm (started trying about 1ish) and was rushed to theatre at 3:15pm. The anethetist "fiddled" with it when I arrived in theatre which made it work well enough for the section. Had he been unsuccessful with that, I would have had a GA. Lying on your side will only make the epi effective for as long as you stay on your side. I think I had a 5 minute grace when I rolled over and that was it - then I felt the contractions again... so much so I still needed the gas.
Talk to your anethetist and see what they say. They will be able to tell the probability of them being able to get the epi (or spinal) in successfully by looking at your x-ray.

HTH

MG

[AnyDream]

I wonder why they didn't get me to try that when I had my CS. They just all of a sudden told me that they had to give me a general and wacked the mask on my face

C'smumma, it sounds like you still have many unanswered questions. Perhaps it would be helpful to make an appt with the hospital to go through your records so that someone can explain the decisions that were taken...there may have been reasons that you're unaware of that made the GA appear necessary to them, or it may be a case of treatment policies, but either way an explanation is probably better than you wondering about it for the rest of your days.