Expert: Dr Ian Jackson - please note UK based - 2/6/2010

Question
I am 26 wks with my 2nd child & am wondering if an egg allergy would stop me having an epidural or spinal block? In the past i have had (wisdom) teeth out under general & had a couple of 'weird turns' for a cple of days after, also sinus op (general again) & was 'gassed' to put me under & felt (almost!) great straight after coming round!
With my 1st child i had pethadine & was very 'out of it' for the best part of 10 hrs (Zombie-like!?! not sure if he drugs did this or trauma & exhustion)...so i would like to ask if i should need epi/spinal is there a likelihood of some similar reaction?
Due to the midwife led care in my area i would hope it will not be needed but wont be able to ask this until the big day & i might not be in a 'fit state' to take it all in!!
many thanks

Answer
Hi there
This is very interesting as most people with egg allergy have no real problems with anaesthesia. There is a vague link to some egg proteins with one of the main drugs used to put you to sleep - propofol but this is easily avoided. The last anaesthetic you had involved breathing a special agent until you went to sleep - probably the anaesthetic called sevoflurane. This totally avoided the propofol and one has to suspect this is why you felt better.
As an anaesthetist I dislike pethidine as it does have a multitude of effects and can leave you feeling spaced out for several hours without providing much in the way of pain relief. I would avoid it given your previous experience.
Now epidurals and spinals are totally different. The Obstetric Anaesthetists Association has a good leaflet that can be found at the link below (sorry you will have to copy and paste it!)
http://www.oaa-anaes.ac.uk/assets/_managed/editor/File/Info%20for%20Mothers/PR_l...
The bottom line for you though is that these techniques involve no egg linked substances and they take away the need for pethidine or any other centrally acting pain killer they may offer you.
My advice to all mothers is to keep an open mind, especially with the second baby your labour maybe quick and entonox might be all you need. If you are finding it tough then consider asking for an epidural rather than having an injection of pain killer.
Hope the above helps and that all goes well.
Dr Ian Jackson