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Epidural anesthesia It is a relatively safe technique, and used by the majority of women in their deliveries, however there are some situations that contraindicate puncture and the administration of this type of analgesia.
Before putting the epidural, the anesthetist will assess certain parameters that must be obtained from the patient to assess whether regional anesthesia can be administered or not, there are also some diseases that will cause failed anesthesia or serious complications.
1 - Infection at the puncture site, since it can spread into the epidural space and cause cellulite or an abscess; and in the case of puncture of the dura mater, meningitis can even develop.
Psoriasis, herpes and axillary hydroadenitis are also considered contraindications. Also generalized sepsis (infection) is another absolute contraindication.
2 - The AIDS it is considered a relative contraindication, and each woman's situation will have to be evaluated.
3 - Neurological condition: These are cases to study in detail, since in many cases epidural anesthesia will not be administered if you suffer from some of the following neurological diseases: demyelination, peripheral neuropathy, cerebrovascular accident ...
4- Coagulopathy: the practice of any type of regional anesthesia presumes the intact state of the coagulation mechanisms.
If a woman has a diagnosed clotting disorder, or heparin is administered during pregnancy, they are also considered relative contraindications to the use of epidurals.
5- Uncontrolled bleeding: since the epidural can cause a drop in blood pressure due to the dilation of the blood vessels, in women with frank bleeding it can be aggravated by the administration of drugs. However, medications can be used to control tension (vasoactive) and put fluids to maintain blood volume.
6- Certain heart disease: some cardiac alterations called "low output" as well as heart block are two heart conditions that contraindicate epidurals. We also fear pericarditis.
7- Technique rejection: subarachnoid or epidural analgesia should not be attempted in patients who do not want it, however, it is always desirable and convenient for the patient to know the benefits and risks of these regional anesthesia techniques, through a detailed, friendly and patient explanation by the anesthesiologist.
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