Re: What are other alternatives to an epidural during childbirth/scoliosis

This is a typical interesting question.

First of all, I'd like to underscore that my answer will be a general, 
theoretical one, and cannot be viewed as a medical consultation. But I'm 
deeply conviced that the more you are informed before you meet your 
anesthesiologist, the more useful such a consultation will be.

Basically, the presence of rods in your back could increase the risk of 
infection during performance of epidural analgesia. The anesthesiologist 
inserts his needle in the midline in your back, a few centimeters away 
from the rods, and it cannot be excluded, theoretically speaking, that 
one metal contaminates the other (rods/needle) during epidural insertion. 
An other issue to keep in mind is that after operation, the scars along 
your spinal column could lower efficency of epidural analgesia.

It's therefore interesting to consider alternatives to epidural 
analgesia. Nitrous oxide is interesting (you breathe in a facial mask a 
mixture of oxygen and nitrous oxide 50/50), and provides moderate 
analgesia. An other alternative is morphine (more exactly chemical 
compounds derived from morphine), with pretty good effects on pain, but 
requiring close monitoring of the newborn because of potential 
respiratory impairment. And do not forget non-pharmacologic actions 
(relaxation, acupuncture, haptonomia, etc..)

My advice would be: go to your consultation with your anesthesiologist, 
and feel free to ask all the questions you need answered. 
Anesthesia is not only "pushing on a syringe", and the human dimension is 
very important in this job. Trust the woman or the man you will meet, 
imagine how your childbirth will be, and how she or he will help you to 
relieve pain. Don't forget to ask what would happen, regarding 
anesthesia, if a cesarean section had to be performed.

And, the more important in my opinion, trust this woman or man (she or he 
is a professional, such as airline pilots are...). This is the key of 
success (painless childbirth). These moments are great moments in a 
woman's life.

Hope this will help you in a few weeks.

Luc Ronchi, MD
Ped Anesthesia
Hopital de Saint-Nazaire
France