Expert: Ronald Levy, M.D. - 7/16/2011

Question
Hello, I am a 30 year old female. I have gallstones and I am planning to have my gallbladder removed. I will have to go through general anesthesia during surgery and I have some concerns.

Here is some background. I had my first child about a year back and he was born pre-mature. When my water broke, I was at the hospital for 8 days to delay the birth of my child so that he can get some time to develop. I was very anxious and nervous during the stay. I was given the medicine Stadol at one point to reduce my contractions but it caused some serious side effects. My heart rate went up considerably and I felt everything was spinning rapidly. I was not able to tolerate it. The Stadol was then stopped and slowly the side effects went away.

However, during the c-section, I was given an epidural. The epidural caused my heart rate to go very high and blood pressure to go dangerously low. I started having shooting pain on my left hand. The hospital staff did an EKG to make sure my heart is fine. I was shaking uncontrollably throughout the c-section and my heart rate stayed very high and blood pressure very low. The side effects slowly went away after the surgery.

My question is why did I experience this kind of side effect during the epidural? I also wanted to know if the same kind of side effect will happen again during general anesthesia. If so, is there any away to prevent this kind of side-effects. Thank you so much for your answers and advice.

Sincerely,

Tina

Answer
The responses you had were actually normal. An epidural, besides its anesthetic effects also affects your sympathetic system. This is the system that controls your blood pressure. The epidural causes your blood pressure to go down. The body's response to low blood pressure is to increase the heart rate and this is what happened to you. The shivering is also a biproduct of the epidural because of its effects on your peripheral circulation. None of this will be a problem with a general anesthetic (with the possible exception of the shivering).

Don't worry.

Ronald Levy, MD
Professor of Anesthesiology
UTMb-Galveston