Walking epidural

| The move from walking on all fours to standing changed the shape of the hips, narrowing the pelvis, as well as increasing the size of the human skull. This makes delivery difficult and painful. Let's know what the new anesthesia technique consists of: epidural alking for childbirth!

For many centuries an attempt has been made to mitigate it, from acupuncture in China, through coca leaves in South America to epidural in our current society, these are techniques that have been used and are used for this purpose.

Differences between walking epidural anesthesia and traditional epidural

It is a type of anesthesia that can be administered when it is in its active phase, with regular contractions, and a minimum dilation of 2-3 cm with a shortened neck and with the fetal head that is well inserted in the pelvis. To administer this type of anesthesia, the patient must be seated or lying on her side and the anesthetist places a catheter between two vertebrae in the epidural space, that is, outside the spinal cord and the dura, which is one of the membranes. lining the medulla. A catheter is left in this space so that more doses of anesthesia can be administered throughout labor if the patient needs it.

Traditional epidural anesthesia uses drugs that numb the sensory fibers (those that bring pain to the brain) and motor (those that allow the limbs to move). In the walking epidural combines opioid drugs with anesthetics, which only affect the sensitive fibers and therefore the mobility of the legs is maintained.

Like traditional epidural anesthesia, walking epidural takes about 20 minutes to take effect and therefore during this time the patient is kept lying down. After 20-30 minutes if the patient wishes and after the anesthesiologist performs a small test, she can wander and will be able to move around the room, do exercises with the ball to promote the descent of the fetal head and will be able to go her to the bathroom without the need for a urinary catheter.

Labor pain is different in the first phase of labor, the dilation phase, than in the second, the delivery phase. The walking epidural is effective when administered in the first hours of the first phase of labor. since if it is done when the patient already has an advanced dilation, the effect is much less.

In any case, some studies claim that 40% of women who are administered the walking epidural choose not to walk during dilation and that only 11% walk during the expulsion phase.

Does walking epidural have contraindications?

Contraindications for this anesthesia are the same as for conventional epidurals. Women with a low platelet problem or a bleeding disorder may not be given this anesthesia because of the risk of bleeding into the spine. In addition, women with an active infection are also contraindicated due to the risk of spreading the infection to the central nervous system. In women with a large deviation of the spine or with little space between the vertebrae, it can be difficult for the anesthetist to find adequate space to administer the medication.

It is a very safe technique for both the mother and the fetus, but sometimes after the administration of the drugs the patient may become dizzy due to hypotension and the fetal heartbeat may lower the heart rate due to the hypotension itself. More rarely and after 24-48 hours, a headache may appear that forces the mother to lie down for a few days. The walking epidural also has a higher incidence of nausea than the traditional epidural and of patients who report an itchy stomach due to the effect of the opioid drug.

Specialist in gynecology and obstetrics