Re: [ozmidwifery] Epidurals - entering the bloodstream

[Helen and Graham]

Here is a section directly dealing with epidural drugs entering the blood stream taken from the article I posted below - I haven't gone on to read the article quoted as the source tho.....it does state that it is a side effect tho.

"Drug-related side-effects



Opioids









To: <ozmidwifery@acegraphics.com.au>
Sent: Tuesday, December 12, 2006 10:34 PM
Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream

There are a number of drug-related side-effects associated with epidural opioids and local anaesthetic agents. Respiratory depression: this is due to the action of opioids on the respiratory centre. Respiratory depression may occur at two different time intervals. - Early: usually within 2 hours of the opioid injection. This may occur if high blood levels of the opioid follow absorption from the epidural space into the systemic circulation (Macintyre & Ready 2001)." ----- Original Message ----- From: "Helen and Graham" <[EMAIL PROTECTED]>

http://www.blackwellroyalmarsdenmanual.com/sample/mars29.htm



Helen


To: <ozmidwifery@acegraphics.com.au>
Sent: Tuesday, December 12, 2006 8:57 PM
Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream

The above link is a very in depth look at epidural drugs and their mode of action. ----- Original Message ----- From: "Kelly Zantey" <[EMAIL PROTECTED]>

They are very well referenced, which is why I was surprised when she
challenged me on it as I knew Sarah uses lots of references (her articles
are on my site) - but if you read the bit about the drugs going into the
bloodstream there is no reference for that.

Here's the discussion, might be easier to understand. I'm not arguing the
point, but want something solid to come back to her with.

http://www.bellybelly.com.au/forums/showthread.php?t=26236

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler
Sent: Tuesday, December 12, 2006 8:35 PM
To: ozmidwifery@acegraphics.com.au
Cc: Kelly Zantey
Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream


is:

25) Fernando R, Bonello E et al. Placental and maternal plasma

From here: http://onyx-ii.com/birthsong/page.cfm?epidural


---- Kelly Zantey <[EMAIL PROTECTED]> wrote:

Sarah's article's are so well referenced. One of the reference's included concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179

Thanks Janet - a few of those links are not working.




the Sarah Buckley article she says is not adequate as the comment about

The main thing she wants is actual medical study/evidence articles - e.g.

the

drug going into the bloodstream is not referenced back to anything. she

has

been trying to find such evidence everywhere but it has turned up

fruitful.

So not just the risks being quoted, but actual evidence.



Oh well, if it does it for them then that's what we have to do :-)



  _____

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser
Sent: Tuesday, December 12, 2006 4:49 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream



Here are some useful sources for the risks of epidurals. Funny how women

are

told to avoid alcohol and soft cheeses in pregnancy but encouraged to

imbibe

powerful and dangerous drugs in labour.



Drugs in labour twenty years hence.

 <http://www.midwiferytoday.com/artic...ugsinlabour.asp>
http://www.midwiferytoday.com/artic...ugsinlabour.asp

epidural information

 <http://gentlebirth.org/Midwife/epirisks.html>
http://gentlebirth.org/Midwife/epirisks.html

A little excerpt


Quote:



childbirth educator) See Thorp, J.A. & Breedlove, G (1996) Epidural

Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are "none" (re the hospital employed Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for

a

good review of the literature.
. hypotension 12 - 23%
. maternal fever - (then unnecessary antibiotic therapy - then the yeast
infection - then.....) one study cited an increase of 0.07 Celsius rise

per

hour exposure to epidural anesthesia. another reported 5% of fetuses

reached

cores temp in excess of 4Celsius, another found a statistically

significant

increase in maternal temps > 38C associated with EA.
. inadvertent spinal ( and headache to follow - which a blood patch does

not

always cure - the incidence depends on skill of operator.... July - new
residents - expect a huge increase in spinals in the teaching

hospitals.....

)
. pruritus, nausea and vomiting. (no numbers here - but more likely with
spinals)
. backache - significant more women c/o backache following EA (RR 1.
. fluid overload- ?pulmonary edema???
. infection from epidural site
. resp arrest
. anaphylaxis
. nerve damage
Henci Goer on epidurals
 <http://parenting.ivillage.com/pregn...a=adid=16053332>
http://parenting.ivillage.com/pregn...a=adid=16053332

Epidurals: can they impact breastfeeding?
 <http://parenting.ivillage.com/pregn...0,,h1nz,00.html>
http://parenting.ivillage.com/pregn...0,,h1nz,00.html

Epidurals: real risk for mother and baby - Sarah Buckley
 <http://www.acegraphics.com.au/articles/sarah02.html>
http://www.acegraphics.com.au/articles/sarah02.html

The Epidural Express:
Real Reasons Not to Jump On Board
by Nancy Griffin, M.A., AAHCC
 <http://birthrites.edsite.com.au/Epidural.html>
http://birthrites.edsite.com.au/Epidural.html

Medical Risks of Epidural Anesthesia During Childbirth
 <http://www.healing-arts.org/mehl-madrona/mmepidural.htm>
http://www.healing-arts.org/mehl-madrona/mmepidural.htm


From: Kelly <mailto:[EMAIL PROTECTED]>  Zantey

To: ozmidwifery@acegraphics.com.au

Sent: Tuesday, December 12, 2006 4:42 PM

Subject: [ozmidwifery] Epidurals - entering the bloodstream



Hello,



Can anyone point me to a medical source or evidence which proves that

she has tried to find medical sources but can't find them anywhere.



Best Regards,



Kelly Zantey

----- Original Message ----- epidural anaesthesia enters the bloodstream? Someone in my forums has said

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