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Epidural Anesthesia

At the culmination of approximately 40 weeks of pregnancy, a woman will begin to experience labor. Labor signifies the impending delivery of the baby. To help alleviate the discomfort of childbirth, many women will elect to have a procedure called an epidural to numb the lower body.

Prior to this procedure the woman may be given an IV infusion of fluids to help maintain blood pressure. A fetal monitor is also placed on the woman's abdomen to monitor the baby's heart rate.

The woman is then asked to lie on her left side and bring her knees upwards towards her abdomen. However, this procedure is occasionally performed with the woman sitting up with her back rounded.

Once she is in position, the doctor locates the appropriate section of her spine, cleans the area, and injects a small amount of local anesthetic to numb the skin at the injection site. Regardless of her position, the woman must remain very still while the doctor slowly and carefully inserts a fairly large needle into her spinal column.

After the needle is advanced slightly, a syringe is attached to the end of the needle. The success of the procedure hinges on placing the tip of the needle in a space that lies just outside the membrane surrounding the spinal nerves.

The membrane is called the dura, and hence the procedure is a called an epidural, and the space, the epidural space. Once the needle reaches the epidural space, a "loss-of-resistance" is detected, and the plunger releases saline into the space.

The syringe is detached and a thin catheter is threaded through the needle into the epidural space. Medication is then administered continuously through this catheter, numbing the lower portions of the woman's body and reducing the discomfort of childbirth.

There are several potential complications associated with this procedure that should be discussed with the doctor prior to the procedure.