Why epidurals fail

The epidural medication has difficulty diffusing into the injured areas of patients with back pain and sciatica. Disk herniation could cause scarring which could slow the diffusion of the medication or block it altogether. Untreated scoliosis could make it difficult for practitioners to find the epidural space and reduce the spread of epidural anesthetic medication, among other complications.

When dealing with an unpredictable fast labor, the epidural block will not set up on time which will lead to an ineffective epidural. In my case, I think my labor was unpredictably fast. Next time I hope to have a better epidural experience and I will keep you all posted if I do! Save my name, email, and website in this browser for the next time I comment. Notify me of follow-up comments by email. Notify me of new posts by email. This site uses Akismet to reduce spam.

Learn how your comment data is processed. This is my story and the reasons why epidurals may fail to work. Why do epidurals fail? Epidural Needle or Catheter Issues An epidural may not work if the initial epidural needle placement was not adequate or the catheter was not positioned in the epidural space correctly.

I think, however, that what you may be refering to as failure of the epidural to "work" is actually not a true epidural failure. The nerves that cause labor pain from contractions are easily blocked by epidural placement for the nerves that travel from T10 to L1 typically speaking, uterus cervix and perhaps even the upper vagina. The second stage of labor, as the baby drops lower, causes pain to result from a different set of nerve fibers-namely the sacral nerves posterior pain and perineal pain, lower vagina.

Our anesthesia team and nurses do a good job to provide adequate education for our patients that epidural labor is not pain free labor and as labor progresses and the baby moves down, epidurals block low pain less. This may result in pressure type pain sensations during second stage.

We reassure the patients that often times this means they are getting close and that this pain will assist in directing pushing efforts. Anesthesia will still come up and evaluate these cases and give boosts when appropriate.

Next time you have a patient who's epidural "isn't working", try checking their block with ice or alcohol wips. If their block is up to their umbilicus and they are still having pain, chances are their epidurals ARE working, just not for the nerves being stimulated. The most common pain we have trouble blocking at my facility is suprapubic pain and low back labor. It can be frustrating as the nurse, because lets face it, pain free is best if you ask me!

But knowing WHAT is going on for you and your patient can help. This also allows you to let your patient know that their epidural IS helping her some. Thank you!! As a result, she was numb in the wrong areas of her body. In addition, she was numb in the bottom halves of "the girls," which caused a problem when her son breastfed. He wasn't latched on correctly, so she didn't feel blood blisters developing due to the numbness. This mom ended up having to ask for the epidural to be removed and reinserted higher up so she could get the numbing, pain-relieving effect.

If she opts for more children, she and her partner or doula will have to consult closely with her gyno and anesthesiologist to ensure proper insertion of the epidural. Sometimes, the anesthesiologist will "miss" the correct epidural area of the spine. When they do this, spinal fluid actually begins to leak out of the spinal column. Specialists say that these accidents do happen and the headache can be a real aftereffect of the mistake in placing the needle.

One thing that can help mom with the headache is to drink a diet soda with caffeine. The caffeine in the drink works to alleviate the pain. One thing: While mom won't get any more headaches afterward, the headaches she does get will be noticeably worse. A blood patch can also stop the slow leak of spinal fluid. They work by "plugging" the tiny holes caused by the dural puncture. A small amount of mom's blood can be injected into the epidural space, where the mistaken punctures are.

Once the blood patch has been completed, the headache goes away. Some pregnant moms have a low tolerance to pain, which makes choosing an epidural a natural for them.

Because of their low tolerance to pain, they may be predisposed to epidural failures. This isn't good news for anyone! So, what are they to do? Along with opting for medicated pain relief, they can discuss other pain relief options with their gyno. These include prenatal yoga, which helps them with stretching Water birth, hypno-birthing going through hypnosis so they are able to help themselves with the pain and finally, just not asking other women what their birth experiences were like, are other options.

Inevitably, they'll run into someone who experienced the Birth from Hades. These moms then have X number of months to ruminate over those TMI details and wonder, "Will my birth experience be that bad?

If moms with a low tolerance to pain are truly worried, then the best thing for them to do is discuss their fears or concerns with their gyno and, ahead of the big day, speak to an anesthesiologist at the hospital where they plan to give birth. If a pregnant mom has a BMI of 30 or more, there's a chance just a chance! The extra padding on her back makes it harder for the anesthesiologist to find that epidural sweet spot where the needle should go.

Anesthesiologists rely on their sense of touch to find the right area and, when it's covered with a layer of fat, it's easy to miss the spot. Once the correct spot has been found, the doctor will need to use a longer needle. This makes it easier for them to ensure the catheter stays in place. However, with a longer needle, they may accidentally puncture the dura the strong membrane surrounding the spinal cord. If this happens, mom will have a horrific headache after giving birth.

Mom should also make sure she meets with an anesthesiologist before she goes into labor. At that meeting, she and the doctor will go over what a higher BMI does to epidurals. One thing the doctor may suggest is that mom receive her epidural earlier in her labor. An early epidural means that, if mom needs an emergency C-section, she's ready.

On the other hand, an early epi may wear off too soon. This well-known phenomenon works on the relationship between the mind and body. In controlled drug studies, some study participants receive the drug under testing; others get a placebo, which is like a sugar pill that has none of the drug being texted.

Usually, none of the participants knows whether they are getting the drug or the placebo. Some of the participants who get the placebo report an improvement in their symptoms while others report that they feel the same as they always do. Epidurals can work in a similar way. If a laboring mom believes her epidural will fail, then she'll feel the pain of each contraction. If she feels the epidural will be effective, she won't feel contractions to the same extent.

If a woman has had more than one child and a previous epi has failed, she's likely to go into labor with a negative impression of every other epi she may receive, though she may hope that it'll perform better this time. A woman and her partner may wait too long to leave for the hospital. Maybe she wants to be sure she's really in labor.

Once she gets there, she's in active labor and either in transition or very close. In this case, the labor and delivery staff won't agree to give the mom an epidural because it's too late for it to be effective.