Other Pain Control Methods for Labor

Spinal block - Pain medication, usually a narcotic, is injected directly into the spinal fluid. The procedure takes about five to 10 minutes to complete. Pain relief is immediate. A spinal anesthetic "blocks" sensation from the waist down. Unlike an epidural, the effects of a spinal block last only a few hours.

Combined spinal/epidural - This was the method of pain control used in the Northwestern University study. This one-two punch pain reliever is performed simultaneously. The spinal anesthetic is injected immediately. Once the effects of the spinal block begin to wear off, the epidural medication is then administered in dose increments.

The advantage of using both approaches is that patients can get immediate pain relief with the spinal block and still be able to walk around, since the medicine injected-narcotics-- do not cause muscle weakness. Once the epidural medication is delivered, leg muscles may be affected, depending on the epidural dose, and the patient may need assistance moving about.

The combination has been coined the "walking epidural," and has been popularized in the United Kingdom, explains anesthesiologist Jeffrey Katz of The University of Texas Medical School at Houston . It gained favor from the theory that walking sped along labor and delivery. "In surveys, the majority of American women have repeatedly rejected the idea of walking through their labors and studies have not consistently supported the notion that walking shortens the birth process," Katz says.

Systemic drugs - Pain medication, usually a narcotic like Demerol or a tranquilizer, is given to the patient intravenously. The medication affects the entire body, rather than just at the source. As a result, systemic drugs mostly relax the patient rather than completely block the pain of contractions. One disadvantage of systemic drugs is that they cross the placenta, and can affect the baby. The baby may be sleepier after delivery, which can interfere with initial attempts at breastfeeding.

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UPDATED: 5-06-2005

About Dr. Gilstrap:

Dr. Larry Gilstrap is chairman of the Department of Obstetrics and Gynecology at the UT Medical School.

See Dr. Gilstrap also at:

I Want My Epidural!

Health Tip:

Fireworks
Don’t lose your independence
on Independence Day!

They’re beautiful, hypnotic, inspiring and dangerous. Each year, thousands of injuries occur from fireworks. The Centers for Disease Control and Prevention (CDC) cite

In 2006, 11 dead and an estimated 9,200 treated in emergency departments for fireworks-related injuries in the United States.
An estimated 5 percent of fireworks-related injuries treated in emergency departments required hospitalization.

Most injuries involved:

Hands (2,300 injuries), eyes (1,500 injuries), and the head, face, and ear (1,400 injuries).
Burns were the most common injury type to all body parts except the eyes and head areas, where contusions, lacerations and foreign bodies in the eye occurred more frequently.

Most common fireworks involved:

Firecrackers, associated with the greatest number of estimated injuries at 1,300. There were 1,000 injuries associated with sparklers and 800 associated with bottle rockets.
Sparklers, accounting for one-third of the injuries to children younger than 5.

Between 2000-05, more than one-third of the fireworks-related deaths involved professional devices that were illegally sold to consumers.

According to the American Academy of Ophthalmology, if you are going to light firecrackers:

Use a specially designed stick, or "punk," rather than a match to light fireworks.
Have a bucket of water ready.
Always follow manufacturers' directions and dispose of used fireworks properly.
Never give a firecracker or sparkler to a child.
Never use a bottle rocket.
Do not light firecrackers bigger than your pinkie, do not light them indoors, and avoid relighting duds.
Never put fireworks in your pocket, throw them while lit, or make homemade firecrackers.
In case of eye injury, do not touch the eye. Tape a clean paper cup over the eye to prevent contamination or further injury. Immediately seek medical attention from an ophthalmologist (eye MD).

What is banned nationwide: Any firecracker with more than 50 milligrams of explosive powder and any aerial firework with more than 130 milligrams of flash powder is banned under federal law, as are mail order kits and components designed to build these fireworks.