Expert: Ronald Levy, M.D. - 4/7/2011

Question
Hi Dr. Levy,

Do you have any experience in epidural anesthesia for labor?  I am due to give birth in a few weeks and would like an epidural.  However, many local anesthetics do not work for me or give me very limited pain relief.  Long dental procedures are out of the question for me unless I can be put under general anesthesia.  Can you tell me what medicines are usually used for an epidural?

Thanks!  Allie Watts

Answer
We generally use bupivicaine which is a long acting local anesthetic. It is often combined with a narcotic and it is very rare that it does not work. Generally, when an epidural doesn't work, it is patchy (meaning the patient feels pain in some areas but not others), but this is usually due to anatomic problems. The difference between you previous locals and this is that in an epidural we place a catheter into the epidural space and we can keep adding local until you feel relief. When you get local for other things they have to give you another shot. Since we often do cesarean sections with an epidural, that means that we will certainly be able to give you pain relief.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston