epidural vs spinal block?

Angel5218

I apologize if this has been brought up before, I don't get a lot of time to browse the forums...

I am having my second c-section in 13 days (or sooner since I am starting to get some contractions). My first was an emergency and I already had an epidural b/c it was an induction and the pit contractions were very painful. This time the doc said they would just give me a spinal block and put some pain meds in on top of it...the block would last around 4hrs and the pain meds 24hrs.

He says the spinal is a smaller needle and overall an easier way to numb me. I am always scared about the idea of getting anything stuck in my spine and wanted to know if its basically the same as an epidural (along with the same risks). I know my SIL almost passed out during her epidural b/c her blood pressure dropped and my friend had it back up into her chest b/c they laid her down too soon and she could not feel herself breathing (that one scares me the most).

I don't know anything about blocks and was just curious if there was any real difference.

Sorry if this post sounds a bit spacy, I haven't slept in a few days (due to these contractions....if only they would either stop or start getting close enough together to warrant going in)

CDMay2006

Personally, I would choose an epidural bc a spinal block enters the spinal cord (which I am not comfortable with) and an epidural does not.
It is a single injection by needle (iirc), whereas the epidural is a catheter that remains in place for an extended period of time and the medication is delivered through the catheter.

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spinsoffresonance

Yeah like PP said, they're both similar the main difference is that with the epidural they leave a catheter in your back while the spinal is a single injection. The anesthesiologist will make the final decision whether you get a spinal or epidural when you're in the OR. I wouldn't worry about it and just let them do what they think is best for you.

mrspayne86

Maybe it's just a doctor's preference but I don't have a choice. Spinals are used with all planned c-sections and I'm okay with that.

Angel5218

Thanks ladies, sounds good. Glad to know its not directly injected into the spinal cord, that freaked me out a bit.

I assume they know what is best, I just never had any experience with the block. Sounds like the experience will be very similar to the epidural.

bribri5285

I had to have two spinals in two days (I've never had an epidural so I can't compare), but here are my thoughts on the spinal...

Be aware that the numbness can go up into your chest. My first spinal was done because they were turning the baby and since I was already over due they gave my a spinal so they could go right into the c section if they were unable to turn the baby. At some point I felt the need to cough and was unable to because those muscles were relaxed. I then started panicking a little feeling like I could breathe. And as a result if my panicking and the pressure of the baby i ended up with low blood pressure issues. I think if I had known ahead of time it might feel like i couldnt breathe and that you could be numb that far up i would have been ok. Also during the first spinal I really wanted to move my legs and I was also kind if panicky that I couldn't.

My second spinal was the next day because the baby had turned itself breech again. Honestly when I found out I had to have a c section I had a melt down and part of it was because I didn't want the spinal. They said it wouldn't be as bad because the pressure of the baby wasn't there for that long. I have to say it was better sort of knowing what to expect. Although the second time I threw up and there again those muscles were all relax so it was very bizarre and hard to throw up.

The actual pain of getting the spinal wasn't bad. The numbing shot was like a bee sting.

emwaiting

I had the spinal and the process wasn't bad except I got a spinal headache afterwards and that was AWFUL!  It was instant pressure in my head and it felt like it was going to burst.  That was the worst part of the c-section.  It went away for a little while but then I ended up having a blood patch a day later which is where they take blood from your arm and then put it back in the same spot they did the spinal injection.  Headache went away but then the night I got home from the hospital it came back and I had the blood patch done again the following day.  I am apparently one of the lucky ones because the nurses said they only happen to 2% of people and then 99% of the time 1 blood patch does the trick but I needed 2!  

emberlee3

emwaiting said:

I had the spinal and the process wasn't bad except I got a spinal headache afterwards and that was AWFUL!  It was instant pressure in my head and it felt like it was going to burst.  That was the worst part of the c-section.  It went away for a little while but then I ended up having a blood patch a day later which is where they take blood from your arm and then put it back in the same spot they did the spinal injection.  Headache went away but then the night I got home from the hospital it came back and I had the blood patch done again the following day.  I am apparently one of the lucky ones because the nurses said they only happen to 2% of people and then 99% of the time 1 blood patch does the trick but I needed 2!  

A spinal headache can occur with either epidural or spinal anesthesia, or just a simple lumbar puncture.  The risk is lowest with a spinal because it's the smallest needle and the quickest procedure.  Also, blood pressure dropping is common with both types.  Really, they are very safe procedures, and most people have no complications from either type.  Much safer than general anesthesia.  Good luck with your c/s, OP.

Kissimi21

I've had both and prefer the spinal.  With DS1, I had an epidural.  It worked fine, but it took a long time to wear off.  It was weird to mentally move my legs, have nothing happen, and then watch my legs move on their own minutes later.  With my twins, I had an epidural that was not inserted properly.  It did not numb the pain.  I ended up feeling 28 hours of back labor, two attempts at turning Baby A, and ended up so physically exhausted that I could no longer push.  They gave me  spinal, which did go too high and left me feeling like I couldn't breathe.  I didn't know that was a possibility, so I freaked out a bit.  The anesthesiologist raised my head and shoulders and then I felt fine.  The spinal wore off quickly and I was ready to walk within hours. 

Angel5218

Thanks again for sharing your experiences. After talking to the doc I feel that I am ok getting the spinal, it seems the risks are about the same with both. My friend did get a spinal headache with her epidural so I knew that was possible with both. The part that worries me the most is not feeling like I can breath. I already have a panic disorder and, knowing how I react to these things, I feel I would have an anxiety attack if I couldn't feel like I could breath, but knowing ahead of time maybe I can relax myself and just focus on feeling myself breath through my nose and mouth.

Its crazy b/c last time I had no time to worry about these things, but with a planned c-section I am freaking out about every aspect of it. I had a NST done Monday and my LO is still breech (head and feet up, butt down) so even if I go into natural labor the vbac is out (I wasn't wanting a vbac but agreed that if I went into labor prior to my date and everything looked good I would try).

Just 6 days to go. Thanks again for the info!

Karadee1

I was worried about having a panic attack as well, so I warned the anesthesiologist about my history of anxiety. He said he could give me something before the baby came out but it might make me sleepy - I asked if he would hold off until baby was born. I ended up not getting anything, but it made me feel better to know he was ready to medicate me just in case.

CDMay2006

JandACoffee said:

CDMay2006 said:

Personally, I would choose an epidural bc a spinal block enters the spinal cord (which I am not comfortable with) and an epidural does not.
It is a single injection by needle (iirc), whereas the epidural is a catheter that remains in place for an extended period of time and the medication is delivered through the catheter.

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The bolded is completely wrong. The spinal does not enter the spinal cord. It is injected into the spinal fluid that surrounds the spinal cord. blockquote>

ack. Yep, I misspoke. I don't have any information about the placement along the length of the cord, though.