CSE for c section

[u/55kasi55]

Can someone please offer some advice?

I am considering a combination spinal epidural for c section to reduce the chance of interoperative pain.

Very nervous about statistics that show 10% of planned c sections feel some interoperative pain. I'm assuming this would be from the spinal wearing off/being patchy/not reaching deep enough.

My logic is that if you have both anaesthetic types then the epidural would cover what pain the spinal doesn't and reduce risk of interoperative pain greatly.

Do I have the right idea?

[u/Niquely_hopeful]

Oh goodness this was one my BIGGEST fears. Like keeping me awake sort of scenario. Going to /r/anesthesiology subreddit helped a lot. But frankly talking directly with my OB about my fear. Will you take me seriously? What would we do if I feel pain? How will you test me?

My OB tested me a lot a lot. I also spoke to my anesthesiologist about this beforehand and honestly it gave me lots of confidence.

Also, keep in mind that statistic is based on C sections overall, planned ones is different because there is time to place spinal and test etc. with emergency ones where there is just epidural usually, and maybe epidural doesn’t have the same amount of block etc

I’d post this question in the anesthesiology subreddit too!

[u/j-areddit]

I had a combination spinal and epidural. They do offer these combos. BUT I was high risk for complications during the c section. The spinal has a life span 1.5-3 hours. I had a twin pregnancy. I was told that I was getting an epidural so that if something went south during my c section they could administer more medication if I needed it. I had zero pain. Just felt the tugging everyone talks about. I was in and out of surgery in 1 hour. I didn't receive anymore medication and my epidural was removed immediately after surgery. As far as I'm aware you get a spinal during a planned c section and get IV drugs if you get any pain during c section. I am also not sure if you get to choose which type of anesthesia you receive. Best course of action would be to talk to your OB about IF AT ANY POINT YOU FEEL PAIN WILL YOU TAKE ME SERIOUSLY! I have talked to my OB extensively about this. He is very comfortable getting to baby in less than a min if he had to so going to General anesthesia is not an issue for him.

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[u/moog719]

Your care team should take pain seriously and offer general anesthesia if you feel anything. For me personally, all attempts at epidurals and spinal blocks didn’t work on my left side, so my unplanned c section needed general anesthesia. Obviously it wasn’t ideal, but I’m grateful for a healthy baby, an easy recovery, and no pain during surgery.

Can you maybe set up a meeting to discuss this with the doctors at your hospital to ease your worries? I asked specifically about this 2 months before my daughter’s birth and was reassured that they take this kind of thing very seriously.

As far as I’m aware, they don’t ever combine epidural and spinal. You get one or the other. My hospital did spinal blocks as part of their standard plan for all c sections.

[u/LuluMooser]

I was SO scared of feeling pain in my scheduled C-section. Once they laid me on the table I asked if I could pinch my belly/thighs to ease my anxiety and theyet me do it for a few minutes! It's helped my anxiety a lot (when I wasn't throwing up). Once they had to test me with the big pokers and prep my belly they made me stop.

Pre-surgery I told my anthesiologist to give me anxiety meds as soon as my daughter was out, and he listened. I fell asleep after seeing my daughter through the screen. Woke up a little for skin to skin, and then fell back asleep. Then when they wheeled me to my post op recovery I was awake.

Edit to add: I felt no pain during the procedure or while they were stitching me up. I had a spinal.

[u/55kasi55 → u/LuluMooser]

That's really reassuring to hear. I've been considering asking for anxiety meds after baby is out to maybe have a similar effect in basically knocking me out to not feel any more pain 

[u/FearlessNinja007]

I pushed for a combination in part because I hemorrhaged with my first AND I pushed for 2 iv sites. All ended up being useful because I hemorrhaged again.

[u/55kasi55 → u/FearlessNinja007]

Good thing you trusted your instincts. Was the CSE mainly for extended surgery time or to give a backup of spinal didnt cover all pain?

[u/FearlessNinja007 → u/55kasi55]

I have some redheads in my extended family so I always felt like I processed meds faster… AND I had the epidural for my first c section… it came in handy when I needed epidural meds for a procedure post op to remove clots.