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Epidural anesthesia: whether the risk is justified?

Что такое эпидуральная анестезия?
What is epidural anesthesia?
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Epidural anesthesia means administration of anesthetics of drugs to the area of a waist through a catheter. Drugs affect only those nerves which bear signals from that part of a body which feels pain at the time of delivery. As a result of anesthesia the area of a stomach loses sensitivity that significantly facilitates process of childbirth. For the first time this method of anesthesia was offered in 1901 by the German doctor Korning.
Как происходит процесс обезболивания?
How there is an anesthesia process?
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Penetration into an epidural space is carried out by means of a long needle with a stylet to which connect a catheter. Through a catheter anesthetic also comes to an organism. Anesthesia begins to work 15-20 minutes later. At the same time the patient can feel weight and numbness of extremities, a muscular tremor. Today epidural anesthesia – one of the safest types of anesthesia.
Какие осложнения могут возникнуть?
What complications can arise?
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According to researches, complications can arise approximately in 0,02% of cases. It can be allergic reaction to anesthetic, or sharp falling of arterial pressure. The remote effects of anesthesia consider headaches and dorsodynias, the proceeding several months. The most terrible effects are a numbness of extremities, bleeding in a spinal cord, a hematoma.
Противопоказания к эпидуральной анестезии
Contraindications to epidural anesthesia
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It is forbidden to do epidural anesthesia to patients with inflammatory diseases and deformations of a backbone, at traumatic shock, intestinal impassability, a tumor of a brain, intolerance of anesthetics, peritonitis. At obesity of the second and third degree, and also at advanced age anesthesia is carried out carefully as reduction of volume and distensibility of an epidural space is observed.
Можно ли проводить анестезию при гипотонии?
Whether it is possible to carry out anesthesia at hypotonia?
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Long time persistent hypotonia was a contraindication to carrying out epidural anesthesia. Now this problem is successfully solved by means of necessary doses of normal saline solution which normalizes pressure. In general, doctors are unanimous in opinion that in the absence of contraindications epidural anesthesia - the most preferable option, irreplaceable in the solution of many medical tasks.
Когда показана эпидуральная анестезия?
When epidural anesthesia is shown?
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This type of anesthesia is used often in combination with the general anesthesia that allows to reduce its doses and blood loss. The combination of these types of an anesthesia also allows to reduce probability of complications from respiratory and cardiovascular systems. Apply epidural anesthesia during operations on bodies of reproductive system, at liposuction and an abdominoplastika. But most of all it is widespread in obstetrics.
Обезболивание родов
Labor pain relief
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In the West several decades apply epidural anesthesia. This fashion came to Russia relatively recently, but also caused a storm of delights in women in labor. It significantly relieves pains during the pains, at the same time the woman remains in consciousness, and anesthetic does not influence negatively a fruit. But there is a theory that epidural anesthesia can become an obstacle for psychological attachment between mother and the child.
Немного фактов
It is a little facts
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About 40% of the women in labor who are giving birth by means of epidural anesthesia have a puerperal depression as they do not feel great love to the child as it occurs in the course of natural childbirth. By the way, on the unknown so far to the reason, approximately from the 20th epidural anesthesia does not affect 1 patient.
Когда эпидуральная анестезия обязательна?
When epidural anesthesia is obligatory?
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For today doctors surely do epidural anesthesia at Cesarean section, rapid and premature birth and polycarpous pregnancy. In all other cases this type of an anesthesia is not obligatory, and doctors even advise to suffer from pain at the time of delivery not to break natural balance of this of the most difficult, but at the same time, the happiest moment in life of each woman.
Оправдан ли риск?
Whether the risk is justified?
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The English scientists revealed that approximately every fifth woman and her child has side effects after an anesthesia. Pains quite often become weaker, obstetric aid (nippers, a vacuum extractor or the stimulating drugs) often is required. It is known that stimulators influence a nervous system of the child that can be shown in hyper excitability. And mechanical tools can lead to birth trauma.
Снижение артериального давления
Lowering of arterial pressure
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One of possible complications of an epidural anesthesia is the lowering of arterial pressure. It can lead to disturbance of inflow of blood to a placenta and cause a hypoxia in a fruit. And the hypoxia is extremely dangerous to development of brain white matter. These effects are dangerous that they are shown not at once, and approximately by two years of life of the child. Disturbance of the speech and disorder of behavior of autistic type is observed.
Быть или не быть?
To be or not to be?
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From all aforesaid it becomes obvious that epidural anesthesia – one of the safest and effective ways of anesthesia. The risk of complications is small, unlike the general and other types of an anesthesia. But, nevertheless, if there is an opportunity to do without anesthesia, then it is better to refuse it. If there is no desire to suffer from pain, then it is necessary to address the good specialist and to accurately follow his instructions.

 

 
 
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In the aspiration to pull out the patient, doctors often go too far. So, for example, a certain Charles Janszen during the period from 1954 to 1994 endured more than 900 operations on removal of new growths.