The Ups And Downs Of This Method Of Spinal Anesthesia

To epi or not to epi? Here's a look at the ups and downs of this method of spinal anesthesia.
Chart from The American Society of Anesthesiologists

  • Usually provides excellent pain relief
  • Small amount of medication is used, so you remain alert
  • Not very much medication reaches the baby
  • Safer than general anesthesia, if cesarean section is required


  • May provide inadequate or patchy pain relief
  • Necessitates immobility, precluding walking or other movement that may help labor's progress
  • Decreased pushing urge and ability
  • Possible shivering, itching
  • Usually requires urinary catheterization
  • Requires continuous monitoring to detect complications and/or progress
  • Reduces experience of birth; mother becomes observer instead of full participant

    Risks to the mother

  • Fever
  • Serious drop in blood pressure
  • Malpresentation or malposition
  • Since it may interfere with progress, increased need for Pitocin
  • Increased need for forceps and vacuum
  • Increased need for cesarean section
  • Severe postbirth headache
  • Long-term backache
  • Severe complications are very rare but include paralysis and death

    Risks to the baby

  • Medication crosses placenta
  • Septic workup and NICU care if maternal fever develops
  • Complications due to forceps, vacuum or cesarean section delivery
  • Respiratory depression
  • Increased likelihood of fetal distress due to mother's low blood pressure
  • Short-term neurobehavioral changes, including irritability and
  • Tags: anesthesia

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