What is the best time to perform an epidural?

Painless delivery performed by epidural anesthesia. This is a method where the doctor will insert a small catheter into the epidural space and pass anesthetic through the catheter according to a preset program with the aim of reducing pain for the mother during labor.

Anesthesia through the catheter into the epidural space will block the nerves in a certain area of ​​the body that are innervated by the nerve roots. Since then, it leads to the effect that the pain stimulation caused by the contractions from the uterus to be transmitted to the brain is reduced, making the mother feel pain relief and reduce the perception of contractions. However, epidural analgesia uses a low concentration of local anesthetic, so it does not affect contractions, does not affect the outcome of labor, does not affect the mother's sense of urgency and labor time. At the same time, with the effect of an epidural, it helps to speed up the process of clearing and opening the cervix.
Epidural anesthesia has the effect of blocking nerve conduction, the anesthetic penetrates directly into the nerves, so the rate of drug in the blood is extremely low and this anesthetic also does not cross the placenta and breast milk. so it absolutely does not affect the baby during labor as well as after birth. This is a safe and widely used method in the world to relieve pain during vaginal delivery. With this method, the mother can avoid the feeling of labor pain, the labor becomes lighter, the mother is completely comfortable feeling each stage of the birth and does not lose strength. Thanks to the effect of pain relievers, the obstetrician can direct the delivery in the best direction for the mother and the fetus. At the same time, it also helps to make the process of cutting the episiotomy painless and reduce local edema.
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Epidural analgesia is the only medical indication that is not prescribed by a doctor but by the women themselves. Pain is a subjective sensation that is mainly assessed by the mother herself. A mother who has been diagnosed in actual labor (active labor) can have an epidural at any time she feels pain. Depending on each woman, the perception of pain may be different, maybe when the cervix is ​​dilated 1-2cm, you can feel the pain or later when the cervix is ​​dilated from 4-5cm, the new woman will feel pain. According to most studies, the time when women begin to clearly feel pain is when the cervix is ​​2-3cm, mothers can notify the doctor to perform pain relief for themselves at that time. this.
After epidural analgesia is administered, the anesthetic will require 10-15 minutes for maximum analgesia and the anesthetic will be administered according to a preset program based on the parameters and conditions of the patient. adjusted based on the pain level of the pregnant woman. The mother will be continuously monitored for pulse indicators, blood pressure as well as fetal heart rate and contractions throughout labor. You will find relief from pain and comfort during labor until the delivery of your baby.
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To maintain the epidural, at present, Vinmec International General Hospital uses a system of automatic intermittent pumps. So what is the role of the automatic intermittent pump in labor pain relief?
Maintain the effect of pain relievers continuously for pregnant women. Anesthesia regimens are calculated and set based on indicators such as the mother's height, weight and pain level, ensuring the most appropriate level of pain relief. Pregnant women can enjoy maximum pain relief and still feel the contractions as well as the progress of the labor stages. The settings of the machine can be changed to suit each stage of labor, giving the mother the most comfortable and gentle feeling. In addition to the automatic pump, the mothers also used a manual button (PCEA) to pump the medicine through the epidural catheter when the mothers felt pain. With a hand button is also installed with an automatic pump to ensure that the mother's dose of medicine is within the allowable limit, does not affect the labor process and does not affect the safety of mother and baby. .
The epidural technique is a popular technique with a very high level of safety and maternal satisfaction rate. This is an appropriate option to help birth mothers feel less pain and feel more comfortable during the birth of their baby. However, during and after an epidural procedure, problems can occur with a very low rate, such as: difficulty performing the procedure, after anesthesia, the mother feels cold, shivering, and itchy. or the anesthetic effect is not enough, uneven leading to poor analgesic effect or failure. Depending on the case, the anesthesiologist will manage or may repeat the epidural procedure if necessary.
At Vinmec International General Hospital, pregnant women before giving birth will be examined and consulted by experienced and professional anesthesiologists. Before, during and after birth, epidural analgesia is usually performed, which are continuously monitored by pain relief doctors and nurses, helping mothers have the safest pain-free birth and welcome their baby soon. .