Expert: JM Starkman, MD - 9/28/2010

Question
I am scheduled to have a c-section in March of the coming year, and I am terrified at the prospect of the spinal block.  I've had two previous c-sections with spinals and had terrible experiences with both.  The first time it took the doctor five times to place the catheter. During the second, the catheter was inserted too far causing a horrible "electric shock" down the right side of my body.  Both experiences were very painful.  I am very ticklish and hard to numb which makes the doctor's job even more difficult.  I have a three part question.  First, can a topical anesthetic be used before the lidocaine is administered?  Second, is there anything that they can give me in my IV before the procedure to take the edge of and calm my ragged nerves?  Lastly, is there anything I can do in advance to prepare myself for the procedure to make the process easier on myself and in turn the doctor? Thanks so much for your help!

Answer
Anything administered to you insofar as 'taking the edge of' [sic] affects the fetus as well as the mother---that's why spinals which really have little or no direct fetal effects are used in the first place.  Ask the anesthesiologist to use Ethyl chloride prior to injecting his local anesthetic, which is pretty standard stuff and should help considerably!  Since you've had 'terrible' experiences with both prior c-sections, have you considered a general anesthetic this time around?