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Last updated: 11/24/2009
The primary problem associated with receiving epidural anesthesia is low blood pressure, otherwise known as hypotension, because of the blocking of sympathetic fibers in the epidural space. The decreased peripheral resistance that results in the circulatory...
system causes dilation of peripheral blood vessels. Fluid collects in the peripheral vasculature (vessels), simulating a condition that the body interprets as low fluid volume. A simple measure that prevents most hypotension is the infusion of 500–1000 cc of fluid intravenously into the patient prior to the procedure. Ringer's lactate is preferable to a solution containing dextrose, because the elevated maternal glucose that accompanies the rapid infusion of solutions containing dextrose can result in hyperglycemia in the newborn with rebound hypoglycemia.
It is important not to place a woman flat on her back after she has an epidural because the supine position can bring on hypotension. If a woman's blood pressure does drop, then the proper treatment is to turn her on her side, administer oxygen, increase the flow of intravenous fluids, and possibly administer ephedrine if the hypotension is severe. Very rarely, convulsions can result from severe reactions. Seizure activity would be treated with short-acting barbiturates or diazepam (Valium).
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An epidural is a local (regional) anesthetic delivered through a catheter (small tube) into a vacant space outside the spinal cord called the epidural space.
The drugs commonly used in epidural anesthesia are bupivicaine (Marcaine, Sensorcaine); chloroprocaine (Nesacaine); and lidocaine (Xylocaine). The solutions of anesthetic should be preservative-free.
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An obstetrician/gynecologist, commonly abbreviated as OB/GYN, can serve as a primary physician and often serve as consultants to other physicians.
From: womenshealthchannel.com
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