Epidural Vs. Spinal

Updated on February 10, 2009
R.L. asks from Reno, NV
36 answers

I am having a repeat C-section later this week and would like advice from those who know about their preference on epidural vs. spinal anesthisia. I had an epidural the first time, but also was in labor before the C-section. This time around it is planned and the hospital says I will most likely get a spinal. I guess my main worry is that it will begin to wear off early and I won't have the pain relief I need. Maybe I am crazy. LOL Thanks in advance for the advice

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G.A.

answers from San Diego on

I've had 2 c sections and the spinal is just fine. I remember it not wearing off fast enough. I remember being in the recovery area and trying to wiggle my feet. They wouldn't let me go to my room (and be with my baby) until I could move my legs. I was determined and anxious to get to her. Good luck! You will be fine.

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T.T.

answers from Las Vegas on

I choose to go with the spinal the second time around. They last a little longer and also the needle they use is thinner. THat can make a big difference in repeat because of the srad tissue that forms.

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T.H.

answers from Los Angeles on

Epidural is the name of the method they use to deliver the drugs (usually Bupivicaine or Ropivicaine and Fentanyl). The spinal utilizes the same drugs injected in the same entry place in your spinal cord -- the primary difference is that the spinal goes into the spinal cord itself, while the epidural line goes into the dura space which surrounds the spinal cord. It's definitely possible to get the 'spinal headache' from a spinal, but they can now fix that in the hospital with a blood patch before you go home.

Whether my clients have a spinal or an epidural, they have the same level of pain relief during the surgery, since the anesthesiologist can increase the amount of medicine in the epidural so that it's just as strong as the spinal ... and the pain relief lasts longer. The thing I've found most important for my clients is not whether they have a spinal or an epidural, but whether the anesthesiologist gives them Duramorph (a morphine derivative) in their IV immediately after the surgery! The Duramorph puts them right to sleep so that they have a MUCH more difficult recovery and are unable to breastfeed in the recovery room because they can't wake up.

My clients who have had repeat surgical births have insisted that the anesthesiologist not give them Duramorph with their second surgery and they have been much, much happier with the outcome -- they are alert and awake and can enjoy their first few hours with their baby.

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S.B.

answers from Los Angeles on

My c-section wasn't planned, but was a spur-of-the moment kind of deal since they were concerned about my health. Point being, I wasn't in labor. They skipped the epidural for me because I have scar tissue in my lower back and went straight for the spinal. It took two tries to get me numb (again, likely due to the scar tissue), but the second worked like a charm. My understanding is that with an epidural, they leave the line in and can keep adding medication as needed. The spinal is more like a shot. Not a comfortable shot, mind you, but doubtful any worse than the epidural. The surgery itself happened so quickly - I think I was sewn back up within half an hour - that the spinal did not have time to wear off. I hope this helps put your mind at ease. Congratulations!

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S.H.

answers from Honolulu on

I had 2 c-sections, Epidural each time, and numb on my bottom half of my body.
It was fine.

What exactly is the 'spinal' anesthesia? A "spinal block?" My Doc just referred to it as an Epidural...in my case.

As far as my experience, there is a tube/line in your spine, and the Anesthesiologist closely monitors this and your vitals etc., and the amount of drugs in you. My Anesthesiologist was also talking to me almost the whole time to gauge me and how I was doing. It was not scary.

I could not feel anything, but of course was fully awake and my upper body too. My Doctor was in and out and finished with the operation in 45 minutes. He assured me, my Epidural would not wear off.

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K.F.

answers from Los Angeles on

Hi R.,

I had Spinal's with both of my c-sections with no problems at all. It didn't wear off until about an hour after the surgery. Don't worry about it wearing off too soon. It's better than a spinal that can last for hours. And also I didn't get any headaches with the Spinal that I've heard some women talk about.

Best of luck - K.

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L.S.

answers from Los Angeles on

All four of my children were c-section. The first, I was in labor and got an epidural.....for the twins, it was a spinal, and for the last boy (2004), that, too was a spinal. So, it won't wear off (well, none of mine did), as they monitored me and my pain level so closely I never felt a thing...a little tugging, but no pain.
God Bless You during this time.....He'll take great care of you.
Sisterly,
Mom 2 Four

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A.M.

answers from Los Angeles on

hi there. i have had 2 c-sections in the past. i had an epidural with the ist one and with my experience,it wore off after the 3rd hour and had to have the anesthysiologist come up every hour by the hour to administer more as the anesthesia wore off after each hour. my labor was a grueling 18 hours. the 2nd cs was scheduled so they did the spinal , which served me well at the time. there was no time for it to wear off as the anesth. did it just right before the operation itself. i can only say that the experience on the second one with the spinal is so much better and will do it again if given the chance and will not consider epidural ever again. in addition, with the spinal, a lot of centers prefer this mode for elective c-secs as it has a faster and more reliable effect whereas the epidural is slow acting and does not completely eliminate the sensation to the incision site like the spinal does.headache is the most common side effect, but i have very little or no price to pay at all as i am just fine even years later. then again, that is your body and i don't recommend the decision to be made solely on your own, i strongly suggest you discuss it with your spouse or partner and mostly with your OB doc and anesthesiologist before your c/s to see what the best option is suited for you and your piece of mind. good luck to you, hope whatever decision you make works out for you, and an early congrats to the birth of your child.

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G.W.

answers from Los Angeles on

Hi R.,
Congratulations on your soon to arrive baby!

I had two emergency c-sections. My first delivery was with a spinal and the second with an epidural ( I had already received while in labor). I found that the spinal actually worked better than the epidural for pain control during the delivery. I still had some sensation on my right side while on the epidural, and it took the anesthesiologist some time to figure out why I was still feeling sensation. Well, I made it through the delivery but once they started sewing me back up, I felt it! They knocked me out completely at that point. Not my favorite way to spend the first few hours of my sons life :)

I know my story is unique to me, but should I have another c-section in the future, I think I will request the spinal again.
I hope all goes well!
G.

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T.

answers from Las Vegas on

R.,

I've had both a spinal for a planned c-section and an epidural for an VBAC (vaginal birth after c-section). Honestly, it doesn't make a bit of difference. I was totally numb both times. The only real difference is with a spinal they don't leave the tube in your back. But the whole c-section takes about 10 minutes. You won't "thaw" out in that time.

:-)T.

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V.A.

answers from Los Angeles on

Hi R.-
I asked that same question when I had my twins. The anesthesiologist said that the difference between the two is that the spinal is a stronger dose for a shorter length of time. The epidural is a lesser dose for longer lengths of time, which is appropriate for long labor. So for a planned, scheduled C-section, you will only need to be numb for the procedure which is like a half hour. Otherwise, if you were in labor with an epidural like you did before, they would just strengthen you dose for the c section. Hope this put you at ease. Good luck and congratulations! V.

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K.J.

answers from Los Angeles on

Same situation for me although, I wasn't given an option and received a spinal. If for some reason you were given an option, you should let the doctor explain the difference pros/cons. I remember being extremely comfortable during the procedure and after I slept for quite a while. I understand your concern but they are quite good at pain management these days so you shouldn't worry. Good luck!

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M.S.

answers from Los Angeles on

I've had both for c-sections. I had a spinal with my first and an epidural with my second. If we have a 3rd, I'll request a spinal. I didn't like the epidural at all. Everyone has different experiences so that is just my opinion. Best wishes and congrats!!!
M.

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N.B.

answers from Los Angeles on

Hi R.,

You have gotten some great advice already. Here are my 2 cents.

I had 2 scheduled C-Sections. My daughter was born in 2003 and I was given an epidural. It was fine, but did take a while to wear off. I was in very little pain the next day because of the Morphine they put in the epidural space.

My son was born this last March and I was given a spinal. I was not given a choice and when asked about another epidural, my OB said that they primarily do spinals now. I was very nervous because it was something new.

I was lucky that I had a few friends who had had spinals and they were able to tell me what they were like. So I am happy to do that for you too. Please know that everyone reacts differently, but I had some of the same, normal reactions as my friends.

The spinal worked almost instantly whereas the epidural took a while to make everything numb. I felt a warm tingly sensation down my hip (I think it was my right hip) and then I was numb. The one thing that I am SO glad my friends told me was that sometimes the numbness can go up to the bottom of your ribs making breathing a little strange. You won't stop breathing...your lungs are not paralyzed, but you might not be able to feel yourself breathe if that makes sense. The doctors had to keep reminding me to breathe and it was fine.

The spinal wore off about an hour after the surgery whereas the epidural took a few hours to wear off. I liked it wearing off in an hour A LOT better. Something about not being able to feel or move my toes for that long freaks me out...

Now the biggest difference between the two for me was this: for some reason, the medicines they used to numb me made me VERY itchy. I mean, like bugs crawling on me itchy. With the epidural, it was bad, but they gave me some sort of anti-histamine and I was fine. Sleepy, but fine. The spinal made me SO INCREDIBLY itchy that they had to give me IV Benadryl. It took the edge off, but I was still pretty itchy until I fell asleep from the 2 anti-histamines and Benadryl. It was fine when I woke up, but I was not able to breastfeed right away and was sleeping when my daughter came in to see her little brother for the first time.

Both were great in managing my pain the next day. The drugs they give are also wonderful, but you HAVE to take them every 4 hours. Even if you are not in pain at the 4 hour mark because you know come hour 5, you will be hurting.

I hope this helps in your decision. Ask your doctor about the pros and cons too. He/she is really the best resource.

Good luck and congrats on baby #2!
N.

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J.P.

answers from Las Vegas on

I had a spinal for scheduled c-sections with both of my children. It was wonderful! I was numb for hours after the procedure was complete. My son was born at 7:50am and I was still numb in the afternoon. With both of them, I was also given a shot of morphine in the spinal, which gave me pain relief for 24 hours after the procedure. You should talk to your anesthesiologist about this. I didn't require any oral pain medication until the next day!! I would definitely recommend the spinal. The other plus is that there is nothing left in your back, they inject the meds and everything is removed right away.
Good luck!

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I.L.

answers from Los Angeles on

Wow...I thought the epidural was the same as spinal anesthesia...
I had my first epidural prior to a planned C-section. My 2nd & 3rd epidurals were administered while I was in labor with my 2nd & 3rd sons who were both delivered vaginally.
While, in my case, the epidural had worn off by the time I delivered, I have no regrets and would not have done anything differently. I loved the experience of an "almost" natural delivery (which I had to forego with my 1st son).
The timely contractions, using the breathing techniques, the screaming and actually feeling my son coming into this world are memories I will always hold dear to my heart...

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H.K.

answers from Los Angeles on

Do the spinal. It feels the same! I've had four babies with three epidurals and one spinal. There was no difference. Best to you!:)

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R.H.

answers from Las Vegas on

R.,
There's not much difference b/w the two except a slightly higher placement on a spinal and the fact that a catheter will not stay in your back like it would with an epidural. The only reason they put a catheter in your back with an epidural is so medicine can continually be infused throughout your labor. With a spinal you will most likely get something called duramorph (which has morphine in it) that will help with pain control for 24 hours post-op. You probably won't notice a difference! Good luck!

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A.M.

answers from Reno on

Hi R.,
I just had a C-Section 4 months ago. I had an epidural with my first son and a spinal with this one. My epidural had a scary effect on me. I don't know if it was nerve damage or from the epidural but my legs would still go out a month later and I would fall...I fell in the hospital right after I handed my son to a nurse. When I had my C-section I was SO nervous because of the drugs. Well, I talked to EVERYONE I knew who had one and when I went in... I was not scared. I was told that the spinal may cause a shock down my leg as they give me the shot, (ouch, what's happening, am I going to be parilyzed...), well, it happened. The second the needle comes out the shock goes away and no, I am not perilyzed! Then I thought I would have a hard time breathing, (drugs work too well on me so I asked her to use a little less with me), I felt way better than I did with the epidural. I still felt tugging, but no pain. It was kinda cool. Then I sat in recovery for about an hour and over that hour my legs began to tingle and I could slowly feel my toes. It's not a sudden recovery. I felt way more comfortable with the spinal. Also, the surgery only took about 10-20 minutes to get my son out,(then they have to sew you up which takes about the same amount of time), so the spinal worked as long as it needed to. They do this SO often, trust them. Oh, I felt a little loopy. You'll do great and congratulations on your new child. Get sleep now!

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L.M.

answers from Los Angeles on

I have the same history as you: in labor with the first, had an epidural, then ended up having a c-section; 2nd child was a planned c-section and I had a spinal block. The only difference I noticed was that I could feel the spinal block happening as it traveled down my veins all the way to my toes, and it did seem to wear off sooner, but that was great because as a planned c-section, it went quicker, and then I was able to sit up and nurse, etc, much sooner than the first time around when I couldn't feel my legs yet. I will be having another c-section in July and will definitely go with another spinal block.

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M.L.

answers from Los Angeles on

I had 2 c-sections and had a spinal with both and did not have any problems. It took several hours (for me) for it to wear off. Best wishes!

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M.F.

answers from Los Angeles on

I had 2 c-sections, the first following labor. I found the recovery from the second was much easier because I wasn't exhausted. The numbness wore off in about the same amount of time with both surgeries.

I found what helped the most was an abdominal binder and cold therapy on the wound site. I also recommend asking for a prescription strength anti-inflammitory (like Motrin) instead of narcotics. The pain comes from inflammation and the narcotics cause constipation. Using an anti-inflammitory will also allow you to be clear headed unlike narcotics. More than anything make sure you have an abdominal binder, most hospitals will give you one if you have the doctor ask for it. If you didn't get one for your first delivery you will be astounded at the difference in recovery.

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M.E.

answers from Los Angeles on

I had an epidural with my second child and it wore off during my c-section(very unpleasant). The Dr. did a spinal with my third so that it would not happen again. I had no side effects.

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R.F.

answers from Los Angeles on

Hi R.,

You probably heard all of this already, but the spinal is a more complete block. It is more predictable and is preferred by some doctors.

The main reason is the epidural doesn't always numb the entire area desired, whereas the spinal has better coverage.

I hope this helps. My own doctor explained it to me...

All the best,

R.

C.W.

answers from Los Angeles on

R.,
Epidurals can have some serious side effects. My bladder was temporarily paralyzed after I had my second son. Go with the other anesthesia, it sounds like it's just as effective.
Good Luck!

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A.A.

answers from Los Angeles on

Hi R.,

I had a spinal from my C Section last May at Saint John Medical Center in Santa Monica. You do not have to worry about it wearing off for more than 24 hours from the time of your delivery, after which you will be on painkillers as needed.
Your doctor should have your lower legs put into a heated automatic massager to massage the calf muscles all day/night until you regain the mobility in your legs. That prevents blood clots from forming as a result of not being able to move them.
The spinal takes effect in less than one minute and you will lose all feeling from the waist down. When they gave me my spinal, I was sitting up and leaning forward...nurses and my doctor had to support my body once the spinal was administered because I literally fell forward on the table from not being able to hold myself up, and they put me down on the table to perform my C section immediately. It was fine. There is a tiny bit of stinging for about 20 seconds but after that you feel nothing.

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K.G.

answers from Las Vegas on

I just want to warn you on the spinal. I had one when I was 19 for foot surgery. This was in 1986 so I'm sure that things have changed, but make sure you discuss this with the doctor. For some reason, the place where the needle went in did not seal itself back up and EVERY time I sat up, I was hit with an intense headache. I spent a week staying horizontal hoping that it would rectify (this included crawling to the bathroom with my head head down), before going back to the hospital so the doctors could seal up the hole. Basically, my spinal fluid was out of wack. It was awful. Everyone else seems to have had a good experience with it, but make sure you discuss that with the doctor! Going through that with a baby to take care of? I couldn't even imagine! Good luck and congrats!

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J.C.

answers from Los Angeles on

I think the spinal is standard with a planned c-section. I had the same with my two...unplanned the first and had epidural, but they did the spinal with the second. It was fine...no issues. Don't worry about it. I think the spinal is more thorough anyway.
Good luck.

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K.Y.

answers from Los Angeles on

I had a c-section with my son, a little over a year ago. You want the spinal block for a c-section because it will numb ALL of your pelvic area. This insures that you won't feel anything during the procedure and it won't wear off before it's over...it all goes very fast. (An epidural is meant to dull pain but doesn't eliminate/numb everything...that's so you can still push.) Plus you are awake so you are in constant communication with the doctors. It will be fine. Relax and enjoy. Congratulations!

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T.L.

answers from Los Angeles on

hi R.
go for the spinal. i have had both (2 c-sections) and the spinal lasts much longer.
good luck.
T.

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A.S.

answers from Los Angeles on

I concur with everyone else. I also want to assure you that without labor it's a completely different experience. You won't be as exhausted since you didn't have the labor. Good luck and don't be worried! They give you pain killers after to help with any discomfort from the surgery.

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S.A.

answers from Honolulu on

I had an Epidural and they kept giving me drugs so that for 24 hrs I was numbed - it was great! Easier than having to swallow pills every few hours. I have no experience with a spinal though, so I can't say if they are better/worst....

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M.H.

answers from Honolulu on

I had a repeat c-section in 2007 and I was concerned about the same thing. But no worries R., the spinal wont ware off, and you aren't as likely to get the headaches either. I didn't have the same side effects from the spinal that I do with epidurals. Don't worry, it is scary thinking about it, but it is no biggie and it will be over before you know it. Just remember to lay there and focus on your deep breathing and something else that brings you peace, like holding your new baby. Congratulations!!
M.

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C.D.

answers from Los Angeles on

I had a combined epidural/spinal for both C-sections, but the only reason I know that is that I asked. I was told that they routinely do that for C-sections, but they seem to still call it an epidural, and that's all they talked about on the consent forms.

I may be wrong, but I think they use 'epidural' as a somewhat general term. Mine definitely got topped up when I needed it after surgery!

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V.K.

answers from Los Angeles on

The spinal being awake is the best you feel nothing and still get to hear everything that is going on. I have had two c-sections the first I was asleep and that was awful. The spinal keeps you from having pain right away but they give you pain medication to help control the pain. It all hurts no matter what but all worth it in the end.

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A.H.

answers from San Diego on

I've had both. The spinal wore off in 2 hrs. The anestesiologist said he could give me another but I was delivering by that time so I didn't worry about it. I f you're have a planned c section then a spinal should give you adequate pain relief. If you're very concerned about it just ask your dr about it and share your concerns. The hospital usually does what the dr asks for anyway, so just talk to your dr. Tell him what the hospita; told you and go from there.

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