Spinal vs Epidural for c/s --- any BTDT experience?

[bubbaray]

I had an epidural for my c/s with DD (emergency). This c/s will be scheduled. My OB's nurse said today when I was asking about it that they use a spinal for scheduled c/s's -- its faster, less likelihood of spinal headache b/c the needle is smaller.

Anyone BTDT??? I had no problems with my epidural last time (man, I still LOVE that anesthetist, LOL!).

TIA

Melissa

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[Fairy]

Hi there. My C-section was scheduled, but my water broke the day before! Nevertheless, there were no issues that indicated a rush or emeergency, and I delivered several hours later with a spinal block. The spinal block cannot be turned up or down, it's just plain old numb/praralysis. Same way they do epi, in the back, etc. You then immediately swing your legs up onto the table and situate yourself, and within about 40 seconds, maybe a minute, you're 100% numb. You feel absolutely nothing, no pressure, NOTHING. since they're cutting you open, that sounded like the best plan right there.

Spinal blocks last only about two hours, so they're perfect for c-sections. With an epi, you hve to still feel to push, so they're good for thawt, but for real live surgery? Trust me, get the spinal. No matter what, the narcotics are going to make you nauseous (if you're prone to that, which I am), and a needle in the back is a needle in the back; didn't care how big, just that it was pointy and it was going in my back :-).

You'll be fine, no worries. Spinal is the way to go for actual surgery, vs. pushing baby vaginally.

[bubbaray]

Thanks so much for your reply!

For some reason, I recall reading about spinal headaches. I did not have one with my epi, but its something I'd obviously like to avoid!

Thanks for the description of how they get you on the table. I was wondering how that worked!

I don't get much of a choice it sounds like anyway. I didn't get the impression that an epi was an option if it was scheduled. Sounds like a spinal is better anyway (and I like that it wears off quick).

Thanks!


Melissa

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[psophia17]

Not everyone reacts to spinals the same way - I had one for my scheduled c/s, and it lasted for hours. They wouldn't move me from the recovery room to the maternity ward until I could wiggle my toes, and I could just barely manage that 12+ hours after DS was born. I never had an epidural, so can't compare, but if the unmedicate VBAC I'm hoping for doesn't work out, I plan to ask for general.

[MegND95]

My first was a scheduled c/s and my OB recommended a spinal. For the life of me, I can't recall his rationale as to why it was better than an epidural. I had terrible, terrible itchiness starting during the surgery, and it lasted for a good 24 hours after. Not sure what (or if) the spinal caused the itchiness or if it some medication I was given during the course of the c/s. I had epidurals for my VBACs and didn't have any problems. And unlike the pp, I felt a decent amount of pressure, but no pain, during the c/s. It's hard for me to compare the two, since I was given one for a surgery and one for a vaginal delivery. But based on my own experience, I would opt for an epidural, due to the hideous, uncontrollable itching!

[juliasmom05]

Like pp said, I think people can react differently. I had a spinal (intrathecal) for a vaginal delivery. For me, it lasted only a couple of hours and I had no adverse reactions.

Marci

Mom to Julia 4/05

[bubbaray]

All of your perspectives help.

Thanks again!

Melissa

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[Fairy]

The itchiness was from the narcotics. Very common. No way to really avoid that, cuz alot of folks get the itching as a side-effect. Honestly, I barely noticed the itching once the pain kicked back in. I was in alot of pain. It's surgery, so the incision is gonna hurt, of course. I also got the shakes really bad, which is another effect of the drugs. My understanding is that the shakes can happen with an epi, too.

In my experience, a spinal block has alot of the same side effects as a general. Not all, but quite a few.

[bubbaray]

I got the shakes REALLY bad from my epi -- its from low BP I think.

I didn't get the itchiness, but from what I understand its from the narcotics, which I got in my epi too (they boost the epi before the c/s if you've had one for labor). I got an IV of post-surgery narcotics too (morphine?), and no itchiness. Not sure if that means I wouldn't be itchy this time, or if its just luck of the draw each time.

Thanks again -- all the info helps!
Melissa

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[Fairy]

I have to just share one more thing. I have never been numbed like that before, so I was positively fascinated from a purely scientific medical point of view. So, once I went numb, I was in awe. I tried really hard to move my legs. I literally strained and "pushed" to move my legs (not push baby, just strained to move), and the nurse at one point said, "what are you doing?" And I said, "I just want to see if I try hard enough if I can make my brain move my legs," and she gave me this, "you're an idiot" look and said, "well you can't, so STOP IT." She was right, it's impossible. And that was the end of that.

[bubbaray]

He he he -- that sounds like some thing I would do! I didn't with my first c/s, b/c it was an emergency and I was stressed/upset for other reasons.

I remember the weird cold sensation on my chest.... And shaking so bad that I thought they wouldn't be able to get her out. Its a bit fuzzy after that, until I remember the recovery room, and shaking so bad there -- they had to push another IV into me, my BP was so low.

Isn't it funny the things you remember?
Melissa

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[Corie]

I itched like crazy!! I was using my hairbrush to scratch
my body. It felt like I was covered in mosquito bites!!

[daniele_ut]

I had a spinal for my c-section with DS and like the pp felt pretty numb within a minute or so. However, once they started the surgery, I could feel quite a bit, so they ended up adding ketamine to my IV and I had a very weird reaction to the ketamine. It felt a bit like I was floating and it was a scary sensation. The anaesthesiologist later told me that it is a dissociative drug that is a derivative of PCP. It doesn't take the pain away, you just don't notice or remember it. He said a percentage of people react the way I do and they won't give it to me next time. I think I would rather have had the epidural, since then I think they could have just turned it up.

[kimbe]

LOL! I too was fascinated! I remember them transferring me from the OR table to the bed and I was in awe that I couldn't feel a thing. I was also in awe at how fast I went numb after the doc was done putting the spinal in. I kept trying to move my toes --- wouldn't move at all!!!!

[teachermommy]

I had a spinal with my scheduled CS. Worked great- took away all pain. The only weird thing was that it numbed me all the way up to my chest and upper arms. I remember mentioning it to the anethesiologist and he told me not to worry that it was just because I was petite (130 preg weight). He also said that it might feel like I wasn't breathing because my chest would be numb. I'm so glad he warned me because that did happen and it was kind of freaky. I couldn't feel my chest rise and fall. It was also a little hard to hold the baby in the recovery room and nurse because my upper arms and chest (nipples) were numb. Luckily, it wears off very quickly. I did joke that at least it didn't hurt when the baby first latched on!

[HannaAddict]

Petra,

Please tell me you are kidding about asking for general!! Speaking from experience. I had a spinal for my non-emergency but unplanned,"urgent" c-section and it didn't work! I was totally numb right up to the base of my pelvis, then it stopped. By the time they realized I wasn't kidding, that I felt more than just "pressure," I was draped, ready to go and they did a general. Even though the general went as well as it could go, they woke me up immediately after they closed in the OR and baby was right there with my husband, it isn't anything I would suggest. I call my son my "50's baby" since I was knocked out and woke up with a baby in a little blue beanie staring at me. I didn't have shakes, chills or throw up, but was loopy for a long time and my legs were numb to boot! Though I am fine with what happened and just happy we were all fine, I would prefer not to have general again! The only time I was really scared and started to cry was when they said they had to do the general. The loss of control, fear of complications, and that old mantra "one intervention leads to the next" kept ringing in my ears. It seemed like everything was much more serious and I was really worried.

I would see if you could get an anesthesia consult at the hospital before this baby, just in case. Even if you plan on an unmedicated birth. At our hospital, I met with a couple of the anesthesiologists about my last experience and they went through various options to keep it from happening again, if indeed I needed an epi or spinal. They asked a lot of questions, answered my questions and it was actually a really good experience. FWIW, the anesthesiologists, my doctor and every other doctor that's seen my chart is always shocked that the spinal failed, they either ask or look and see who the doc was and are totally surprised. They have all said it is very rare, that it could be not enough medication was given (they rely on it drifting up to the correct spot). Maybe your doctor just was a little heavy handed? I hated the numb leg feeling though too, really weird.

Kimberly

[KBecks]

I guess i had spinals for both, definitely the 2nd. Its not my favorite thing, but I got through it twice. Its not horrible but it was a little scary, esp the 2nd time, dont know why.

[KBecks]

I was itchy after #2 also.

[sdjeppa]

I had a spinal for my "urgent" c/s...they told me it had painkillers in it too that would last for 24 hours - it lasted about 18, at least - definitely helped with that first time standing up!

[psophia17]

Nope, not kidding - I think the hospital I'll be at this time is very different from the one I delivered DS at, but having the nurses come back again, and again, and again, poking me in my numb toes, and standing at the foot of the bed discussing what might be wrong with me was awful. When I did make it to the mat. ward, and they brought me DS, I could hardly hold him b/c of the lack of power in my arms.

I had general a few months later when my appendix came out, and when I came out of surgery and woke up, I wasn't out of it at all - DH had already gone home with DS, but I was physically and mentally able to demand a breast pump, and to tell the orderly where he should go to get one for me, and that I needed several bottles to pump into, b/c it'd been so long since I BF DS. It was infinitely better than the spinal.

It's all going to be outlined in my birth plan, though...in the section I plan not to need :)