Question about Motor and Sensory Blockade
March 21, 2015 | 20,00 EUR | answered by Dr. med. Ive Dr. Schaaf
Hello, I have two questions regarding pain management during a cesarean section with regional anesthesia.
MOTOR AND SENSORY BLOCKADE
1. Let's say one of your patients is undergoing a cesarean section with epidural anesthesia. I have read that there is a motor blockade and a sensory blockade. How would it manifest, and what would the sensations be like during the cesarean section if the motor blockade is not fully eliminated? As a complete novice, I would interpret it as follows:
With an incomplete sensory blockade, the patient would experience strong pain and may need to switch to general anesthesia. With an incomplete motor blockade, the patient might feel instruments in the abdomen, possibly experiencing the surgical procedure more intensely, but only in terms of motor function. However, would there still be pain with an incomplete motor blockade?
Am I correct or incorrect in these conclusions?
2. In the case of a high/total spinal anesthesia, would there be pain afterwards? I would assume not, as the anesthesia would completely eliminate pain due to its high dose and ascent into the spinal space. Am I correct in this conclusion as well?
Thank you!
Hello,
I have attached a link below that describes the procedures in great detail and in a way that is easy to understand, including a comparison of the methods.
First, regarding your last question: Yes, you are right, spinal anesthesia can provide pain relief, assuming correct positioning and dosage.
Regarding your concerns about incomplete blockade, you are correct regarding sensitivity: Incomplete would mean that you still feel pain and further measures would be needed to ensure pain relief, such as general anesthesia.
Regarding motor function, with a complete blockade you would not be able to actively move your muscles, whereas with an incomplete blockade you would still have the ability to move, which may not be relevant for certain procedures, such as a C-section where the ability to move your legs is not necessary. However, for other surgeries, such as leg surgery, an incomplete blockade would be problematic.
The idea that you would feel pressure or pain in the abdomen if the motor blockade is incomplete is not true.
I hope this was clear, if not, please ask for clarification.
Sincerely,
Dr. Schaaf
http://www.dr-gumpert.de/html/spinalanaesthesie.html
