Abstract
M.Cur.
Epidural anaesthesia as a method of pain relief during
labour has lately become very popular. statistics show
that in some labour units up to 70 percent of all patients
undergo epidural anaesthesia. The popularity of this
method can be attributed to its effectiveness in relieving
pain during labour.
The anaesthetist commences an epidural block by introducing
an epidural catheter into the epidural space. The
anaesthetist administers the test dose and the first
therapeutic dose. Within a short duration of time (10 to
20 minutes) the patient can already experience the numbing
effect of the anaesthetic. This anaesthetic loses its
numbing effect within two to three hours and effective
pain relief can only be achieved by administering a
further dose of local anaesthetic via the epidural
catheter. This procedure can be repeated between three to
six times during the average duration of labour.
Alternatively a continuous epidural infusion procedure can
be used. This last method however sometimes requires the
administration of additional epidural "top-ups".
If the additional "top-ups" are not administered timeously
the patient can experience pain and discomfort. These delays
in administering the anaesthetic often occur as a
result of the anaesthetist being involved in the treatment
of other patients - this often occurs in bigger labour
wards where epidural anaesthesia is used during labour and
caesarian sections by various patients. The active involvement
of the midwife in these administrations can prevent
the delays that often occur.