You are explaining to a patient about different modalities of pain relief in labour. The patient has opted for epidural anaesthesia. What level of block is desired for painless delivery by epidural anaesthesia?
An epidural block up to the level T10 will be adequate in preventing pain arising from the uterus and structures below during labour. Epidural anaesthesia should only be given after the onset of active labour. ie cervical dilatation of more than 3 cm. The complications of epidural anaesthesia include postural hypotension, urinary retention and paralysis of pelvic floor muscles. Note: Nitrous Oxide, pudendal block, spinal block, combined spinal epidural block and transcutaneous electrical nerve stimulation are other possible methods for pain relief during labour. Ref: Oxford Handbook of Clinical Specialities, 8th Edition, Page 66.
T11 - L5
T4 - S5
T10 - S5
L1 - S5