Failed Epidural - Can you help Mears...?

[dejags]

Sorry to be a pain Mears but I was really wondering if you could comment on my situation. When I had my first child I asked for an epidural - it was put in twice and both times failed. It did not provide any pain relief at all but did result in a little bit of 'paralysis' in one leg. I found the procedure so uncomfortable and nerve wracking that I would never do it again - the pain of labour was agonising but I would far rather manage with no drugs than try for another epidural.

I am now pregnant again and my question is - is what happens if I medically require a c-section. I understand that in this scenario I would need an epidural and would have no problem having it - what would happen if it didn't work again. Are there are any alternatives - or would this mean I would need a general anaesthetic?

Thanks in advance

Dejags - I think in that case you would get a spinal aneasthetic.... which I am led to believe is different. It is stronger, but doesn't last as long..... just lasts long enough to get the baby out.
I don't know if the fact that an epidural failed means the spinal would fail too though. If so, then it would have to be a general.
But I s'pose this is a possibility with everyone is it not? Sometimes they just don't work.

I'm sure you won't need a caesarian though....

dejags if it was an emergency section and they needed to get the baby out quickly they would give you a general if you didn't have an epidural already in. If it was an elective or they had more time ie failure to progress and neither you or the baby were unwell they would offer you a spinal. Can I suggest that if you're likely to have an elective section you ask your midwife to ask for an anaesthetic consultation for you so that you can discuss this. Is there any reason you think you may need a section?

Dejags - I had an epidural and then the birth went a bit pearshaped and I had to have an emergency section. They tried to top up the epidural but it didn't work so I had to have a GA. The next thing I knew, I came round in a side room to see my little princess. I don't have any bad memories or regrets as to how my daughter arrived in this world - ideally I would have been surrounded by candles at home but what happens, happens.

Maybe discuss your fears with your midwife etc (or mears!) to see what your options are and to cover all bases. Don't worry unnecessarily though I am sure you will be fine and dandy.

Thanks Ladies

I am hoping for a straightforward delivery. DS was induced (drip) but beyond the failed epidural I had no other pain relief. I had pethidine once after a car accident and decided that I would never have it again as it made me feel so woozy, one puff of gas & air produced the same result.

I am happy to have a drug free delivery and hope that there will be no need for a caesarian - interested to see what Mears says and of course I will discuss with my MW

Hi dejags
congratulations on the pregnancy! I was also induced with dd and epidural failed miserabley too for me. At one point they were about to do a c-section as she was stuck and the aenethesistit (please ignore that pathetic spelling attempt lol!) told me I would have to have a general as the epidural had failed twice. Luckily with a ventouse twiddle of her head and I managed to push her out. Hopefully you'll be luckier next time, best wishes.

I totally missed this post.

Dejags, unfortunately one of the problems with an epidural is that it might not work fully. That is not to say that if you needed one again that it wouldn't work - don't rule it out completely incase for some reason you need one.

If however, you labour without an epidural and you need a C/S, it is correct that you will be given a spinal which goes into the space a little bit deeper than an epidural. Only if the spinal didn't work (you would be tested first) would you be given a GA.

As mentioned already it would be a GA if there was not time to put in a spinal such as fetal distress.

The best thing to do regards pain relief is to avoid getting induced and use the pool (if no pool use a bath).
Hope all goes well.

Hi dejags... I had failed epidurals for both my labours.. both times it just 'paralysed' my legs. I ended up with a c-section the first time, and was obviously very nervous that I was going to feel everything but they used different 'extra-strong' stuff through the original epidural needle and it was fine.. no pain from neck down
The second time I was prepped for section but the epidural needed to be re-sited (higher up my back) and 2 lots of the extra-strong stuff was used before I was pain-free.
Make sure that everyone knows the epidural didn't work last time so that they are prepared to re-site the needle if necessary.. I had quite a few hours of unnecessary pain in my second labour because my original aneathetist (sp?!) didn't re-site the needle and didn't return when I was still in pain.
Don't worry too much...they will test how much you can feel before they attempt a section..and they will only do a GA if they really need to!

Message withdrawn

Thanks for that. I am seriously considering a home birth (if I can get DH to buy into the idea ) so hopefully if all goes smoothly I won't be needing that section.

Mears - another question, sorry. The reason I was induced was because my waters had broken and my blood pressure was up (slightly). My BP had been text book throughout my pregnancy and this happened at 39 weeks exactly. Is it likely to happen again?

TIA

Hi dejags strange i had Prem ruptured membranes too and then merconium so they had to induce me at 39 week my epi didnt work either i remember the nurses and doctors not believing me for hours until eventually i just jumped off the bed and proved it to them. I hadnt thought that it might not work this time so ill be keeping up with this thread too!!

It is very common to have a raised BP at the end of a pregnancy. As long as you don't have more (too much) protein in your urine you are fine.
You can go 96hours without an induction (after your waters went) and have no higher risk of infection (provided you had no sweep or internal examination). Mears showed me the BMJ study on that....

Have a home birth and enjoy

Dejags - re your DH: my DP was very, very, VERY anti a home birth. I just went ahead with it. This might well not be the right thing for you and your DH, but I just mention it

dejags - i had five attempts at an epidural with my first (due to my insistence, anaesthetist had had enough of trying!) and also had weird problems moving my legs afterwards but not much effect from the epi as he couldn't get it in the right place, but with my 2nd baby it went in first time and worked fantastically - had forceps, stitches, the lot and didn't feel that part at all - it was just a different day, different doctor but other than that I don't understand why it worked so well 2nd time around. so my advice is keep an open mind, there's no reason to suppose it won't work this time ps. I had pre-eclampsia and lots of swelling with first baby so I've often wondered whether my back was too swollen to get it in properly, whereas 2nd time I didn't have pre-eclampsia

Dear dejags
I too had problems with an epidural - it was not put in right the first time and the consultant and the registrar anithetist failed to site it at all when they tried again.

This time round, my obstetritian has offered to arrange an appointment with the anithetist in advance so that they can look at xrays of my back and work out where - if anywhere - there is a good place to site the epidural. Why don't you see if your hospital can do the same for you?

Dejags - I keep missing your threads, sorry. Blood pressure problems are more associated with first pregnancies. As it was a problem so late in your first pregnancy, it is less likely to be a problem this time round. As Pupuce said, there is more evidence that waters can be broken for longer prior for the need for induction. Hope all goes well for you this time.