One of the biggest differences is the degree of fear and agitation. Sometimes children are too scared of what is expected or some previous experience. Young children are not able to understand what is happening to them, so in this situation the parents can help most. Physiological differences in children require the use of different techniques, apparatus and doses of medications.

The childbirth act, especially for the women who give birth for the first time, may be very painful and almost always there is a need to help the woman in labour. The presence of the fetus is limiting the choice and the quantity of the analgesic that the doctor may administer to the mother. Analgesics used in the treatment of labor pain administered intramuscularly or in a vein are transmitted through the placenta and may cause some undesired effects on the baby after the birth. This is the reason why the dosage that is safe for the newborn is inefficient in treating the labor pain.

On the other hand, medications administerd through the epidural catheter reach such low concentrations in the mother’s bloodstream that they have no adverse effects on the newborn.

Childbirth is special and unique for every woman. Towards the end of pregnancy begin contractions of the uterus, which are rare in the begining, and then they are more often and stronger, which causes the labor pain, which strength is different at every woman during delivery. Towards the end of the birth itself, also, there is the pain of stretching the soft birth canals. The percentige of women in labor who do not ask for pain relief is very small, and the rest have a great benefit of the pain relief. The first time of childbirth is usually the longest and the labor pain is the strongest. There are lots of factors that impact the pain:

• Size and position of the baby
• Strenght of the uterus contractions
• Pain tolerance of the woman in labor
• Pelvis and birth canal dimensions
• Use of stimulation by the obstetrician in order to start or speed up the process of birth

Today around 80% of the women giving birth ask for some type of pain relief.

The most efficient and mostly used techniques are the region techniques, which include epidural, spinal and the combined epidural- spinal analgesia. Their biggest advantage is the efficiency and absence of side effects for the baby. That is also the reason why they are so widely spread in the developed countries, above 90% in some hospitals.

The epidural analgesia is with no doubt the most efficient method in the treatment of labor, especially for the primipara whose childbirth lasts longer than usual. It is available to all the women in labor who are interested. The side effects are extremely rare as use of anticoagulant therapy or infection on the place where the epidural cateter is placed.

The method is consisted of placing a thin epidural cateter (1mm) in the part of spine known as loin after skin local anesthesia. The best time to be placed is when the rhythmical contractions are shorter and more pianful and when the opening of the cervix is 3-4 cm dilated. The procedure is done in a sitting or side position, patient’s knees are towards her abdomen and her chin towards the chest bone, so the back’s loin part should be straight up. The administration of medicine through the epidural cateter near the nerves enables to cut the conduction of pain from the uterus and soft birth paths towards the brain where every sensation is actually formed including the pain..

The effects of the pain relief may be felt after 20-30 minutes, and the medicine is administered constantly through a special pump, until the birth is finished. Mother feels warmness and light numbness in the legs and the lower body, the pain is lost, but the contractions are felt. Throughout the whole childbirth, mother’s blood pressure and her heart frequency are controlled, and through the CTG, baby’s puls and the uterus contractions are controlled.

Spinal analgesia is a rarely used technique and the effect is after 2-3 minutes. This technique is applied only when we expect that the childbirth will be finished in the following 2 hours. Its biggest flaw is that the medicine can be administered only once and cannot be added more times, but, another punction has to be done, if the childbirth is not finished.

The combined spinal- epidural technique uses the adventages of the previous two- fast effect and duration until childbirth is finished. It is mostly used at the so called “walking” epidurals when the patient may be mobile during the childbirth.

In case when the baby is not dropping even though the cervix is dilated, or the umbilical cord is short and holds the baby, childbirth has to be done by C-section. The epidural catheter may be used for the C-section anesthesia, and more concentrated solution of the medicine is administered that blocks in total the legs and the lower part of the abdomen, up to the chest. Thus, the general anesthesia for C-section is being avoided and the mother is awaken so she can hear the baby’s first cry and later to see and touch her baby when put on her chest by the pediatrician. Simply, a moment to remember.

Sometimes there might be some difficulties in locating the epidural area so a slight pain may occur on the puncture spot, it lasts for a day or two and without any complications. There are rare cases when a headache might occur after the epidural analgesia.

Outpatient anesthesia is designed and devised to allow the patient soon after surgery or diagnostic intervention to go home. Short-acting anesthetic medicines and specialized anesthetic techniques as well as post-intervention care are focused on the needs of patients who have come for ambulatory anesthesia and surgery in order to make surgery or diagnostic tests as safe and comfortable as possible. Generally if the patient is in good physical condition and in good health, he is a reliable candidate for day surgery and ambulatory anesthesia.

After short recovery, you, patients, can return safely home. In most of the cases, family, friends can provide all the necessary help that you need. Adequate pain treatment is also included in your home discharge plan that will be prepared by your anesthesiologist and surgeon.

If you already have planned a surgery, you probably have questions about the type of anesthesia, the pain that you can expect after the surgery and some other information that may interest you. The team of Remedika Anesthesiologists will help you get answers to frequently asked questions on this site. Remember though, despite the answers on this page, it is best to consult your anesthesiologist for any information about your health and the intervention that follows.

Your anesthesiologist will interview you the day before the intervention and sometimes on the day of the intervention to gather all the information needed to evaluate your health. Laboratory tests as well as other medical tests can be performed to check your health status for one purpose: greater safety. During the interview you will fill out an anesthesiology questionnaire listing about your previous experiences with anesthesia, if any, your health condition, allergies, medications you regularly use. If you have any concerns you should tell the anesthesiologist and discuss them.

All surgeries, as well as all types of anesthesia, have a certain risk. They depend on multiple factors including the type of surgery and your health condition. Luckily the adverse side effects are very rare, and the anesthesiologist takes all necessary precautions to prevent any such occurrence. When talking to the anesthesiologist you should ask about the risks of anesthesia associated with your surgery or diagnostic test.

The general rule is that you should not eat or drink anything after midnight before your surgery or diagnostic test that requires anesthesia. In some cases you may get permission from your anesthesiologist to drink clear fluids several hours before receiving anesthesia.

Some medications should be taken regularly until the day of surgery, and some should be discontinued. It is therefore very important to tell the anesthesiologist about the medications you are taking, and he will decide which ones to continue taking and which not to. Do not take any medications without permission.

Certain natural medicines may prolong the effect of anesthesia, and others may increase the risk of bleeding during the intervention or raise blood pressure. Some of these effects of natural medicines do not have to be very significant, but still, you have to tell the anesthesiologist about everything you are taking before your intervention.

YES – it is very important to stop immediately. Your surgery may be a golden opportunity to do so. There is evidence that those who quit smoking have fewer symptoms of nicotine addiction and greater success in trying to quit. Although before our intervention or the week before, there is still a great benefit to quitting smoking.

The effects of the medications used in the anesthesia can sometimes stay up to 24 hours before they completely disappear. You also need someone to stay with you for the first 24 hours and provide a care. This is for your safety. Some patients feel good and strong just hours after the intervention and think they are capable of normal activities. That’s not correct! Stay safe!

There are protocols and guidelines in our institution for when you can leave after finishing the intervention. But the most important thing is to get permission from the anesthesiologist after he realizes that you are capable of performing some of the normal activities such as getting up on your own, walking, going to the toilette, not feeling nausea and vomiting, and so on. Sometimes, though rarely, you will have to stay one night in the hospital and this will be arranged for you.

The purpose of this information is to give you answer to some of the possible anesthesia for your child related questions, to explain to you the role of the anesthesiologist and the possible side effects and complications associated with the anesthesia.

The Anesthesiology Department at Re-Medika has a team of doctors anesthesiologists and nurse anesthetists whose aim is to provide quality service to children who come to us and provide as pleasant stay during treatment by:

• Minimizing agitation in children before surgery
• Preparation of children and parents for anesthesia
• Anesthesia for surgical procedures
• Sedation for diagnostic procedures
• Monitoring of vital functions during surgery and awakening
• Minimizing pain and agitation after surgery

One of the biggest differences is the degree of fear and agitation. Sometimes children are too scared of what followes or some previous experience. Young children are not able to understand what is happening to them, so it is parents who can help most. Physiological differences in children require the use of different techniques, apparatus and doses of medications.