Failed epidural and subsequent CS

[AnneLovesGilbert]

When I had DD I had an epidural when I was on the drip which worked brilliantly until the induction failed and I was taken to have a CS. As they started operating I could feel it and they put me straight under so I ended up having a GA and missing her coming out. My notes say it was a failed epidural.

Because of the complications of the delivery I need another CS and am wondering if I’ve got any chance of avoiding a GA. I’m under a great consultant and will discuss with her when I next see her but has anyone experienced this as a mum or working in maternity/obstetrics?

I don't know the answer to this question but I'm sorry you experienced that, it sounds terrible. My experience was similar - failed induction ending in an EMCS - but thankfully the epidural worked so I wasn't under GA. It was still fairly traumatic though and your experience sounds a lot worse.

A spinal block is different to an epidural so hopefully they could do that instead? If it's not an emergency C-section they should have all the time in the world to ensure that you are properly anaesthetised before starting the operation.

When are you due?

For an elective section they use a spinal block, not an epidural, and since it’s not an emergency there’s plenty of time to make sure it’s working as it should with an elective too. My memory is a bit hazy as you know what it like and after baby comes it’s a bit of a blur but I know mine didn’t go far up enough initially and they were moving me about to get it to spread I think, which was really weird because my legs were completely numb at that point! If it had been an emergency that could have been time they didn’t have, IDK.

Hopefully your consultant can reassure you at your next appointment. Or perhaps ask if they can refer you to the anaesthetist ahead of time so you can discuss with them?

Long time ago for me but similar thing happened to me. I was hazy on the details at the time but my epidural had failed/ worn off during a premature labour and I then needed a EMCS. I didn't know at the time but the decision to go GA had already been made (nobody told me!) and I'm still not sure if we went GA because of failed epidural or other reasons. It was a 'crash' EMCS with 32 week twins.

Subsequent birth was a planned CS with no problems. I must have had conversations with the Consultant about it but I can't remember much now!

Thank you all so much for replying, really appreciate it, I know it’s a bit niche.

It wasn’t great but I wasn’t scared and felt in good hands throughout. They increased the epidural once I was in theatre, they used a cold spray to check it was working and I was numb to the underarms by the time the surgeon started but could then feel him making the incision hence the GA. She was completely stuck so I ended up with horizontal and vertical incisions and a complicated recovery. The GA had a bad affect on DD as she came out too though she was over it quickly and we were lucky in that. It honestly wasn’t as bad as it sounds and the care was great.

This one needs to come out at 37 weeks because of my scars, which is in March, and my hope is with plenty of time to plan and knowing it’ll be a properly elective CS things will be more controlled. My worst fear of all last time was a CS, just the thought of surgery 🤯 so I was totally unprepared and it took ages to get my head around it afterwards.

I’m happily on board with a calm controlled CS this time, it’s the only option and I’m so pleased they’re thinking about it already but it suddenly occurred to me last night that if it’s a GA again DH and I will both miss our baby being born again and felt a bit shit about it. Hopefully there’s an alternative.

I’ll have a google about spinals as I’m clueless but is it a different drug or the same thing as an epidural but administered differently?

@AnneLovesGilbert its more common to use spinal anaesthesia for elective sections rather than using an epidural. Spinals are generally more reliable than epidural top-ups and can provide a ‘denser’ block. Even with a good spinal or epidural it is normal to be aware that something’s being done during the operation, but it shouldn’t be painful. It sounds like OP’s epidural was doing something at all the right levels of the back but not densely enough. If someone has pain before the baby’s out then converting to a GA would be normal. There is quite a bit of witchcraft involved in epidurals and deciding which ones look good enough to top-up for theatre and which ones don’t! If someone has an epidural that’s worked well in labour then these will usually work well for surgery, but every so often they catch us out. If someone’s had an epidural that’s been a bit dodgy in labour (eg. given a bit of pain relief but not been great, or worked better on one side than the other) then it’s more common to take the epidural out and do a spinal for an emergency section/forceps delivery.

GA drugs do cross the placenta and baby’s may need a bit of support from the paediatricians until those drugs have worn off (particularly if the emergency is because the baby’s struggling in the first place). This is part of the reason why it’s so common to try and avoid GA in the first place.

@RedVolkswagenBeetle even if someone has an epidural that’s worked well for pain relief in labour, if a Cat 1 section is called then its common to do a GA because that is often quicker than topping up the epidural. HTH.