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Re: Help! Spinal or Epidural for c-section...Mom's & Dr. opinions also PLEASE

From: Kelly Shanahan, MD (anonymous@obgyn.net)
Sun, 28 Jan 2001 16:20:01 -0600 (CST)

At Fri, 26 Jan 2001, Kelle wrote: >
>Hello,
>
>I am hoping you can answer a couple questions for me regarding a Spinal
>for a c-section. I am 31 and this Monday (Jan 29th) going in for a
>scheduled c-section. This will be my 5th c-section. With the other
>surgeries I had epidural's. I have been on Aldomet for Pre-eclampsia (
>Bp was 149/90) for about 6 weeks, my BP is stable and now is 106/80. My
>Dr. recommends the Spinal, stating that it takes effect quicker and
>they can give me 24 hour pain relief as well. I will not get to speak
>to the Anesthesiologist (sp?) until right before the surgery. So I am
>trying to find out as much as I can prior to talking with him/her.
>
>1. I am terrified of the medication going to far up into my chest area,
>thus making me feel like I cannot breath. This happened with one of my
>epidurals. Is it more likely for this to happen with a Spinal?

no

Can they >regulate just how much medication they administer to insure it won't be
>such a high block?

there are ways to decrease teh chances, like using hte right amount of medication for your size, and keeping your head up just a bit if necessary >
>2. How much more likely is nausea and/or vomiting with a Spinal (would
>hate to lay there in the OR getting sick during surgery)

the incidence is pretty low >
>3. Is it true that you DO NOT have to lay flat for 8 hours anymore?

yes, you do not have to lay flat >
>4. How soon does the Spinal start to wear off (ie: when will I start to
>regain feeling in my legs)?

about an hour >
>5. How likely is the spinal headaches? Can they give you medication to
>counteract that should it occur?

spinal headaches are pretty uncommon - about 1 - 2%. There are remedies, boht meidications and a blood patch (basically a tiny bit of your blood injected into the same spot as the spinal to create a blood "bandaid" -- dramatically effective) >
>I sure hope you can give me some advice, I am very nervous about a
>Spinal as I have never had one before, and always heard they are more
>dangerous because they actually go into your spinal cord fluid (ie; risk
>for paralysis).

paralysis risk is essentaily zero

Any advice/comments would be much appreciated. If any >other Moms also out there have had a Spinal in the past I would love to
>hear your opinions on your experiences.
>
>Thank you in advance,
>Kelle

I prefer my patients have a spinal for a c/section -- the block and pain relief are much better than with an epidural (epidural can be patchy, with areas where you may still feel pain), and the onset of action is much, much faster. 

--
M. Kelly Shanahan, MD
S. Lake Tahoe, CA


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