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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2017 Jun 12

DOI: 10.23736/S0375-9393.17.12082-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Failed epidural for labour: what now?

Emilia GUASCH , Fabrizio IANNUCCELLI, Nicolas BROGLY, Fernando GILSANZ

Servicio de Anestesia, Hospital Universitario La Paz, Madrid, Spain


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Labour epidural failure is a challenging situation for the obstetric anaesthetist, especially when associated to high risk of caesarean delivery, obesity, and difficult airway predictors. Labour epidural failure is still not standardly defined, consequently its incidence is uncertain: improving the knowledge of risk factors related to failure will increase epidural block success rate. Prolonged labours, previous history of epidural failure, and repeated topups needed during labour are recognized risk factors for failure. Clinical experience and the use of modern equipment (ultrasound guided blocks), as well as the choice of neuraxial technique (epidural versus combined spinalepidural) may affect failure rate. Softwarecontrolled infusion pumps seem to increase epidural analgesia success rate. Among nontechnical skills, good communication among medical team members and parturients is another pivotal point to achieve a satisfactory analgesia for labour. Clear algorithms should be promoted where epidural failure during labour or caesarean delivery may occur.


KEY WORDS: Labour epidural failure - Labour analgesia conversion - Caesarean delivery

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Per citare questo articolo

Guasch E, Iannuccelli F, Brogly N, Gilsanz F. Failed epidural for labour: what now? Minerva Anestesiol 2017 Jun 12. DOI: 10.23736/S0375-9393.17.12082-1

Corresponding author e-mail

emiguasch@hotmail.com