Cocktail Epidural

[carls]

Can someone enlighten me on the cocktail epidural? It has been recommended to me by a few mums, but I am not sure what is involved.

Have any other mums had good or bad experiences with it?

[JanetF]

It just means giving you more than one kind of drug and a cutesy name to make it sound less like what it really is. A normal epidural involves one form of anaesthetic. While they often mean you can move about which removes one of the major problems epidurals cause - malposition and lack of progress because you're stuck on your back - they also expose your baby to more drugs which are dangerous to it. There are better ways to manage your labour that don't have side effects for you or your baby. I hope you enjoy your research and come to a decision with which you feel comfortable. :)

http://www.acegraphics.com.au/articles/sarah02.html
More recent forms of epidurals use a lower dose of local anaesthetic, usually combined with an opiate, such as pethidine, morphine or fentanyl (sublimaze). With this low-dose or combination epidural, most women can move around with support; however the chance of a woman being able to give birth without forceps is still low4. Another form of epidural, popular in the US, is the CSE, or combined spinal-epidural, where a one-off dose of opiate, with or without local anaesthetic, is injected into the spinal space, very close to the end of the spinal cord. This gives pain relief for around 2 hours, and if further pain relief is needed, it is given as an epidural. These forms of "walking epidural" may seem advantageous, but being attached to a CTG machine to monitor the baby, and hooked up to a drip which is also a requirement when an epidural is in place, can make walking impossible.

There is a noticeable lack of research and information about the effects of epidurals on babies24. Drugs used in epidurals can reach levels at least as high as those in the mother25, and because of the baby's immature liver, these drugs take a long time- sometimes days- to be cleared from the baby's body26. Although findings are not consistent, possible problems, such as rapid breathing in the first few hours27 and vulnerability to low blood sugar28 suggest that these drugs have measurable effects on the newborn baby.

As well as these effects, babies can suffer from the interventions associated with epidural use; for example babies born by caesarean section have a higher risk of breathing difficulties29. When monitoring of the heart rate by CTG is difficult, babies may have a small electrode screwed into their scalp, which may not only be unpleasant, but occasionally can lead to infection.

There are also suggestions that babies born after epidurals may have difficulties with breastfeeding30 31 which may be a drug effect, or may relate to more subtle changes. Studies suggest that epidurals interfere with the release of oxytocin32 which, as well as causing the let-down effect in breastfeeding, encourages bonding between a mother and her young33.

http://www.healing-arts.org/mehl-madrona/mmepidural.htm#painrelief