Indications for this type of anaesthesia are:

• pain (relative);
• the wish of the parturient (relative);
• medical indications;
• complications of pregnancy and obstetric indications.

Contraindications:

• lack of patient consent;
• lack of cooperation with the patient;
• blood clotting disorders;
• platelet count below 100,000 in ml of blood;
• certain heart diseases and defects;
• certain diseases of the central nervous system.

Epidural anaesthesia interferes with labour through 3 mechanisms:

• a decrease in pelvic muscle tone which delays and slows down the rotation of the head;
• a decrease in abdominal pressor tension which impedes the mechanism of pushing;
• a weakening of the Fergusson reflex - involving an increase in endogenous oxytocin secretion under the influence of pelvic diaphragm distension.

Subarachnoid anaesthesia

Used for caesarean sections. The anaesthesia is performed with a very thin needle. The anaesthetist inserts it between the vertebrae into the subarachnoid space; the needle is inserted approximately 1-2 mm deeper than with epidural anaesthesia.

photo: pantherstock

The advantages of this technique are:

• the technique is quick, reliable identification of the subarachnoid space;
• the drug administered is in a low dose minimising the danger to mother and child;
• good muscle relaxation in the area of anaesthesia;
• the patient is conscious at all times; no pain is felt for about 4 hours after the procedure;
• the woman can see her baby immediately after delivery;
• such anaesthesia is a reliable method; there is always an analgesic effect after the administration of the drug.

Side effects are:

• a drop in blood pressure;
• back pain at the injection site
• heart rhythm disturbances;
• nausea, vomiting;
• urinary retention;
• headaches.

General anaesthesia

It is administered intravenously. After its administration, the patient completely loses consciousness. It is also used in caesarean sections.