Epidurals are a common method for pain relief during labor and surgical procedures, providing effective numbness in the lower body. A frequent, temporary side effect after an epidural is shivering or shaking. This response is generally not a cause for alarm, but understanding why it occurs and how it can be managed can offer reassurance.
Why Epidurals Can Cause Shaking
Epidural-induced shaking stems from several physiological responses. A primary mechanism involves the disruption of the body’s temperature regulation system, controlled by the hypothalamus. The medication can affect this center, leading the body to perceive a drop in core temperature, which triggers shivering as the body attempts to generate heat.
Another contributing factor is vasodilation, the widening of blood vessels, particularly in the lower body. This effect, caused by the epidural medication, redistributes heat from the body’s core to the extremities. This shift can make the individual feel cold, prompting the shivering reflex.
The epidural can also impact the nervous system, specifically the sympathetic nervous system. This system regulates involuntary body functions, and an epidural can lead to an imbalance in these signals, manifesting as involuntary muscle tremors. Beyond the physiological effects, the intense experience of labor or surgery, combined with anxiety, can also contribute to shaking. The body’s stress response can result in a surge of hormones like adrenaline and cortisol, which can induce shaking.
Medical Approaches to Alleviate Shaking
Medical professionals employ several strategies to alleviate epidural-induced shaking. External warming is a common and effective initial intervention. This often includes providing warm blankets or using forced-air warmers, which help to increase the body’s surface temperature and counteract the perceived cold.
Administering warmed intravenous (IV) fluids can also help regulate core body temperature. Warmed IV fluids reduce shivering compared to fluids at room temperature. This method directly introduces warmth into the circulatory system, to maintain a stable internal temperature.
In cases where other measures are insufficient or the shivering is severe, medication may be considered. Drugs such as meperidine and clonidine are effective in reducing shivering. Meperidine affects the central nervous system, while clonidine influences thermoregulatory control. These medications are used when discomfort is significant and persistent.
Comfort Measures and Self-Care
Individuals can take several comfort measures to manage shaking after an epidural. Engaging in controlled breathing techniques can help calm the nervous system. Deep, slow breaths, focusing on the exhale, can promote relaxation and distract from the discomfort.
Distraction can also be a useful self-care strategy. Focusing attention away from the shaking, such as through conversation, listening to music, or engaging with a focal point, can reduce its intensity. Adjusting body position to find a more comfortable and warm posture can contribute to overall comfort.
Communicating any discomfort to the healthcare team is important, as they can assess the situation and provide appropriate interventions. A support person, such as a partner or family member, can provide comfort, offering warm items, or simply holding a hand, which can be reassuring during this experience.
When to Consult Your Healthcare Provider
While epidural-induced shaking is generally temporary and harmless, there are instances when it warrants further medical attention. It is advisable to inform your healthcare provider if the shaking becomes persistent or intensifies despite comfort measures and medical interventions. Prolonged or worsening shivering could indicate an underlying issue.
Seek immediate medical advice if the shaking is accompanied by other concerning symptoms. These include a high fever, severe pain not related to labor or recovery, difficulty breathing, or any changes in consciousness. Any unusual or severe discomfort that goes beyond typical shivering should also be promptly reported. Although epidural shaking is typically benign and resolves on its own, reporting any concerns ensures proper assessment and care.