If you are wondering what an epidural is, it is a local anesthetic which is a very common and highly effective method for women going through labour pains. It is also referred to as a “regional blocker” as it prevents sensation in a specific region during labour. Most often, the region covered is from the breasts to the thighs. There are several causes for epidural failure as well.
Defining Epidural Failure
Epidurals are usually administered to women in labour. Medication is injected via an IV catheter into the spine in a specific spot. The catheter is left in place to deliver medication for as long as it is needed by the patient. If the IV catheter is placed in the wrong spot, the medication will not be able to offer the needed relief. There are risks and side-effects to getting an epidural and medication is monitored by the doctor all through labour.
Can epidurals fail to work as intended?
There are instances where the epidural injection/medication fails to act as intended. There are several reasons for this.
- Anatomical location: One of the most common causes of failure is incorrect placement. If the catheter is not inserted in a straight line into the identified spot, it could lead to displacement of the needle. The catheter can also be displaced due to epidural pressure change and it causes extreme discomfort to the patient.
- Position of the patient: This has the chance of affecting the placement of the needle due to the relationship of the tissues and the osseous device. Placement must be chosen carefully to avoid dislodging of the IV catheter and discomfort therefrom.
Many factors are considered in the catheter placement by the anesthesiologist and while the epidural works well for many patients, it doesn’t for a few. 50% of failed cases occur due to incorrect placement of the catheter and others have a sub-optimal experience. Failure rates for thoracic insertion of the IC are 32% and 27% for lumbar.
What to do for relief in case of Epidural Failure:
It is hard to get and deal with an epidural, but managing a failure is easier if the following actions are taken by the patient and the delivery team of doctors and nurses.
- Moving from side to side: Ask a delivery nurse for help in moving as this will make it easy to find a less painful spot. Changes in position may feel helpful as well.
- Higher doses of medication: Anesthesiologists monitor a patient and decide if an increase in medication is called for. They could even decide to change the drug with the catheter in place to offer pain relief during labour.
- Catheter replacement: In most cases, issues occur due to the wrong placement of the catheter. In such cases, removing and repositioning the catheter will offer effective results.
- Medication: As a patient about to receive an epidural, it pays to check what medication will be used and how it works. This will help with contractions and labour.
During labour, the patient can use skills learning during birthing classes like breathing and relaxation exercises. Ask for help from the nurse and if possible, change positions. Remaining calm during difficult labour will help to get through the process more easily.