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Double Block: Understand What Combined Anesthesia


Double Block: Understand What Combined Anesthesia

Dr Norbert D"cruz January 19, 2018

Combined anesthesia: understand what is the double block, the most commonly used anesthesia at the time of normal delivery.

When epidural anesthesia is given along with the spinal cord, doctors are administering anesthesia known as double block or combined anesthesia to the pregnant woman. “In the combination of these, the pregnant woman receives only one lumbar puncture and one needle is inserted inside the other to make the combined anesthesia,” she says. explains obstetrician and gynecologist Erica Mandelli. Learn more about double-block anesthesia below:

Why is double-block anesthesia better suited for normal delivery?

It is indicated in cases of normal birth because the goal is to keep labor until the baby’s expulsive period, without pain for the patient, awaiting the natural evolution of the delivery,” says Flavia Lopes. However, the procedure can not be performed in all women, as Ricardo Boari Coelho explains. “In patients with changes in the coagulation system or with more severe heart disease, the procedure is contraindicated. Your anesthesiologist will ask and investigate these contraindications.”

Double-block anesthesia can also be done during cesarean section. “It is possible to use the catheter to perform anesthesia for cesarean section if necessary. If a cesarean delivery is indicated during labor, it is not necessary to perform a new puncture,” explains the anesthesiologist at the clinic Dr. Flavia Fairbanks Ricardo Boari Coelho.

How is the application of combined anesthesia?

After local anesthesia in the lumbar region, the anesthesiologist performs puncture in the epidural space, in the same way that epidural anesthesia is applied. ” Through this same needle, he inserts a thinner needle and performs the subarachnoid puncture, popularly known as spinal anesthesia, and injects the anesthetic. The physician then withdraws the spinal needle and, through the same epidural needle, positions an epidural catheter, which runs until the end of delivery. Thus, after local anesthesia, the patient only receives a punch and the whole procedure is done through that same needle, “explains Ricardo Boari Coelho, anesthesiologist Dr. Clinic. Flavia Fairbanks.

How does double-block anesthesia work in a woman’s body?

According to Erica Mantelli, combined anesthesia promotes greater pelvic relaxation, with faster pain relief . “Because of the maintenance of the catheter during the procedure, the anesthetist can infuse more anesthetic as needed. The effect will last until the end of labor,” he says. ” It is a procedure that preserves muscle strength and uterine contraction ,” said Flavia Lopes of Sal Lake Hospital in São Paulo.

What are the advantages and disadvantages of combined anesthesia?

The advantage is the speed and power of the spine and the flexibility of the epidural, since additional doses of anesthetic and in different concentrations can be injected at any time during the delivery through the epidural catheter. “These doses can relieve pain vaginally in its various phases, keeping the movement and sensitivity of the legs. As the concentration of the anesthetic is lower, by being diluted anesthetic, during normal labor analgesia pregnant maintains strength and sensitivity, walking, strength and exercises that facilitate delivery, “explains Ricardo Boari Coelho.

Among the disadvantages are the side effects. ” It can lead to vomiting, nausea and, in rare cases, headache and low back pain ,” says Erica Mantelli.

Dr Norbert D"cruz

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