Anesthesia facilitation of external cephalic version: A meta-analysis

A randomized controlled trial of the effect of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation

“…[4][5][6][7] Meta-analyses of neuraxial anesthesia techniques versus control suggest a favorable relationship for both epidural and spinal techniques and ECV success, but have not evaluated if this relationship is dose-dependent among the included trials. 8,11 The three published randomized controlled trials of neuraxial blockade using techniques that resulted in surgical anesthesia (epidural 2% lidocaine with or without fentanyl 100 lg, 4,5 intrathecal bupivacaine 7.5 mg 6 ) reported increased ECV success with neuraxial anesthesia compared to control or no analgesia. In contrast, the current study and one other randomized trial in which neuraxial analgesia was compared to no analgesia failed to demonstrate an increase in procedural success.…”

“…[4][5][6] However, increased procedural success has not been universal, 7 and it is not clear what comprises the optimal analgesic technique in this setting. 8 Considerations in selecting an analgesic technique include fetal safety (risk of abruption and fetal heart rate (FHR) abnormalities), monitoring requirements and side effects. The purpose of this investigation was to determine if ECV was successful more frequently with combined spinal-epidural analgesia than with systemic opioid analgesia.…”

Nitrous oxide for analgesia in external cephalic version at term: prospective comparative studya

“…In general, pain is well tolerated because it only takes a few minutes to complete the procedure. Meanwhile, the associated pain is one of the reasons why the procedure is not more widely accepted and is one of the most widely studied aspects of ECV in recent years [5,10,17,19]. The pain is attributable to the application of rotational and leverage forces at two different points to turn the fetus, which is uncomfortable for the women; indeed, the discomfort is often the limiting factor for the professional trying to complete the maneuver.…”

A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

“…[4,7,12] In this study, the mean NRPS after ECV (±SD) was 4.6 (2.6) and 6.5 (2.7) in the remifentanil and placebo groups, respectively ( P  < 0.001). The satisfaction scores were 9.6 ± 1.4 in the remifentanil group and 6.4 ± 3.7 in the placebo group ( P  < 0.001).…”