In plain words
Neuraxial anesthesia is a group of numbing methods that work near the spinal cord. The two main types are the and the spinal. They block pain in the lower body, and they are the most common pain relief for labor and . With a spinal or epidural for a cesarean, you stay awake but numb from the chest down. Common effects include a drop in blood pressure, shivering, , or a numb or heavy feeling in the legs. Your team watches for these and treats them. Ask your anesthesia team what to expect for your birth.
The deeper version
Neuraxial anesthesia comprises spinal, epidural, and combined spinal-epidural techniques, producing sympathetic blockade and sensory and motor block below the level of injection. In cesarean delivery, maternal hypotension is managed prophylactically, since the gravid uterus and contribute to it; lateral tilt mitigates the compression, and vasopressors treat the hypotension. administration after delivery reduces the risk of . The ASA Practice Guidelines for Obstetric Anesthesia (Hawkins and colleagues, Anesthesiology, 2016) describe technique, monitoring, and management of hypotension. Neuraxial techniques are preferred for most cesarean deliveries in many systems, and outcome studies are largely observational. The controversy concerns the incidence of persistent back pain and the effect of labor epidurals on second-stage duration and operative birth.
Where it comes up
- Planning a cesareanGetting Ready for Birth
- What happens in a cesareanBirth and the First Days
- Breastfeeding after a cesareanFeeding Your Baby
- Pain options: from breathing to epiduralGetting Ready for Birth
What mothers here say about neuraxial anesthesia
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Sources
- Hawkins JL and colleagues, American Society of Anesthesiologists — ASA Practice Guidelines for Obstetric Anesthesia, Anesthesiology (2016)
- Cunningham FG and colleagues — Williams Obstetrics, 26th edition (2022)