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Q: Is there a risk of autonomic dysreflexia with epidural block?
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Why can't you eat after an epidural?

It makes you higher risk of having a caesarean section and occasionally during a caesarean section, if there are complications, you need a general anaesthetic, where you are completely put to sleep. When under general anaesthetic, you have no gag reflex and could be sick and choke on it and die, but if you have an empty stomach, this won't happen


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Is epidural risk?

Although Most Women Have Epidurals With No Problems, There Are Some Potential Side Effects They Should Be Aware of When Choosing This As a Pain Relief Method:Sometimes, an epidural can cause your blood pressure to decrease; this may occasionally cause your baby's heart rate to slow. To decrease this risk, you'll be given fluids through an intravenous line before the drug is injected. Often, just changing your position is all that is necessary to improve blood pressure.After delivery, your back may be sore from the injection for a few days. However, an epidural does not cause long-term back pain.If the covering of the spinal cord is pierced, you can get a bad headache, but this only happens about one percent of the time. It does not always cause a headache, but if one occurs, there are effective ways to treat it. If it's not treated, the headache may last for days, but this is rare.If the epidural has been given for an extended period of time, or if a lot of medication is given late in labor, it may be hard to feel when to push with a contraction. Your labor nurse can help time your efforts if you have trouble, and you should still be able to push effectively.Source: http://www.lifelinetomodernmedicine.com/ArticlePage.aspx?ID=878fabbc-dd11-45d8-8524-fa7831b485a5&LandingID=fc6eb1da-98e4-43c7-bb9f-09c17e2a005d


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Epidural abscess?

DefinitionAn epidural abscess is q collection of pus (infected material) between the outer covering of the brain and spinal cord and the bones of the skull or spine. The abscess causes swelling in the area.Alternative NamesAbscess - epidural; Spinal abscessCauses, incidence, and risk factorsEpidural abscess is a rare disorder caused by infection in the area between the bones of the skull or spine, and the membranes covering the brain and spinal cord (meninges). This infection is called an intracranial epidural abscess if it is inside the skull area, or a spinal epidural abscess if it is found in the spine area. Nine out of 10 cases are located in the spine.The infection is usually caused by bacteria (Staphylococcus aureus is common), but may be caused by fungus. It can be due to other infections in the body, or germs that spread through the blood. However, in up to one-third of patients, no source of infection is found.In the case of an intracranial epidural abscess (within the skull), risk factors include:Chronic ear infectionsChronic sinusitisHead injuryMastoiditisRecent neurosurgeryA spinal epidural abscess may be seen in patients with:A history of back surgery or other invasive procedures involving the spineBloodstream infectionsBoilsBone infections of the spine (vertebral osteomyelitis)People who inject drugs are also at increased risk.SymptomsSpinal epidural abscess:Bowel or bladder incontinenceDifficulty urinating (urinary retention)Fever and back painIntracranial epidural abscess:FeverHeadacheLethargyNausea and vomitingPain at the site of recent surgery that gets worse (especially if fever is present)Neurological symptoms depend on the location of the abscess and may include:Decreased ability to move any part of the bodyLoss of sensation in any area of the body, or abnormal changes in sensationParalysisWeaknessSigns and testsThe health care provider will perform an exam to look for a loss of functions such as movement or sensation.Tests may include:CT scanMRISample of the abscess to determine what is causing the infectionTreatmentThe goal of treatment is to cure the infection and reduce the risk of permanent damage. Treatment usually includes antibiotics and surgery. In rare cases, antibiotics alone are used.Antibiotics are usually given through a vein (IV) for at least 4 - 6 weeks. However, some people may need to take them for a longer time, depending on the type of bacteria and severity of the disease.Surgery is usually needed to drain or remove the abscess. In addition, surgery is often needed to reduce pressure on the spinal cord or brain, to prevent further loss of function.Expectations (prognosis)Early diagnosis and treatment greatly improve the chance of a good outcome. Once weakness, paralysis, or sensation changes occur, the chances of recovering lost function are reduced. Permanent nervous system damage or death may occur.ComplicationsBrain abscessChronic back painMeningitisPermanent brain and nervous system damage (such as brain damage, sensory changes, or paralysis) if diagnosis and treatment are delayedReturn of infection (common even if the disorder is treated)Spinal cord abscessSpread of infection into the bones of the spine or skull (osteomyelitis)Calling your health care providerCall your health care provider if you have:Persistent back pain with feverHeadache with feverOther symptoms of epidural abscessAn epidural abscess is a medical emergency.PreventionTreatment of certain infections, such as ear infections, sinusitis, and bloodstream infections, may decrease the risk of an epidural abscess. Early diagnosis and treatment are essential to prevent complications.ReferencesNath A. Brain abscess and parameningeal infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 438.