Labor pains and drugs used, epidoral (sp)

[mrs_bales]

I was watching Maternity Ward last night on, I think TLC. The show was featuring a woman who had had Harrington Rods put in her back to correct scoliosis. I admit, I wasn’t paying too much attention, but i thought I heard them say, because of her rods, they were unable to give her an eppidoral. I had the same procedure done almost a decade ago. No doctor ever told me anything like that. I hate pain. If this is truly the case, I don’t think I’ll be having kids.

[Duck_Duck_Goose]

Yeah, it looks like Harrington Rods present a problem for epidurals, although it has been done.

http://www.amjanesthesiology.com/stories/storyReader$137

Remifentanil for Labor Analgesia

John A. Dilger, MD, Jonathan H. Waters, MD, and John E. Tetzlaff, MD
Patients with Harrington Rods present a challenge to the anesthesia care team for the provision of labor analgesia. Parenteral analgesics traditionally have been used but have many shortcomings, such as their ceiling effect for analgesia or the possibility of prolonged respiratory depression in the newborn. We present a case in which a remifentanil infusion was used to control pain associated with vaginal delivery safely and effectively in a patient with scoliosis who was treated with Harrington rods.
(Am J Anesthesiol.2000;27[9]:553-554)

http://www.manbit.com/oa/c115.htm

The presence of Harrington rods or similar instrumentation provides another challenge. One group of workers were only able to satisfactorily overcome the technical difficulties in 5 out of 9 parturients receiving epidural block and one of these parturients suffered an inadvertent dural puncture (6). These patients are unable to flex their spines making any approach technically more difficult. In those patients who have not had a laminectomy, insertion of a block needle may be attempted adjacent to a single rod or between the two rods. In one patient with a Harrington rod, a subdural block followed an L5 - S1 epidural puncture (7).

http://groups.yahoo.com/group/csen-anesthesia-mailing-list/message/3155

Subject: [csen-anesthesia-mailing-list] Combined spinal-epidural in the obstetric patient with Harrington rods assisted by ultrasonography

Br J Anaesth 1999 Oct;83(4):670-2

Combined spinal-epidural in the obstetric patient with Harrington rods
assisted by ultrasonography.

Yeo ST, French R
Department of Anaesthesia, King Edward Memorial Hospital, Subiaco,
Australia.

[Medline record in process]

We describe a patient with severe scoliosis, which had been corrected
partially with Harrington rods, who requested epidural analgesia for labour.
With no palpable landmarks, the use of ultrasound enabled identification of
the vertebral midline and allowed provision of regional anaesthesia.

PMID: 10673892, UI: 20138847

[Dr_Paprika]

No reason not to have kids. But you might need a Caesarean under general anesthesia or to use a paracervical block for pain.

[MsRobyn]

Epidurals aren’t foolproof in any case; the first one I had gave incomplete relief; I felt nothing on one side of my body, and pain on the other side.

It’s also possible to have drug-free delivery. I managed to go five hours of a six-hour labor with no drugs at all. A good childbirth education class can help with that, as can any number of childbirth books. Lamaze and Bradley are two such methods.

There are also other pain interventions possible. An intravenous injection can be offered, as can different blocks, including the paracervical block Dr. Paprika mentioned.

I’d talk to an anesthesiologist or CRNA (certified registered nurse anesthetist) before labor about your options.

Robin

[The_Mermaid]

With my first delivery I had a cubic assload of drugs, Nubain maybe? It didn’t make the labor any faster or easier IMO.

With my second delivery, a 10 lb, 3 oz, 23 inch long boy, I had no pain med during the entire labor and only a saddle block about 2 seconds before I delivered. Then it was because they realized the baby was so large there was going to be some repair work needed. He was crowning already, hell his head was out about 2 inches. I sat up, got the shot then laid back and delivered with the next push.

The repair work took about 45 minutes though.

The difference? Lamaze classes. They teach you what are basically self hypnosis tricks for dealing with the pain. You learn to react to it in a non emotional manner. The mind is a powerful tool if used to its fullest extent. Many of us would find we are a lot stronger than we realize.

[NinetyWt]

I had both mine, strictly natural, no epidural, no nothin’.

First: 15 hours. Second: 17 hours.

And, what The Mermaid said. Remember, our bodies were made to have young 'uns.