Spinal versus epidural anaesthesia for caesarean section

Ng, Kar W; Parsons, Jacqueline; Cyna, Allan M; Middleton, Philippa

doi:10.1002/14651858.cd003765.pub2

Cited by 165 publications

(69 citation statements)

References 29 publications

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“…Our findings are similar to those of previous studies comparing primary SA and EA in scheduled CS: a large review of the Cochrane Collaboration reported that SA achieved a faster onset of anesthesia than EA, but that SA required more treatment for hypotension. 12 In terms of the primary outcomes in our study, we found a propensity toward intraoperative use of fentanyl and midazolam in the EA group, although fentanyl use was not significantly different from that in the SA group. In our hospital, anesthesiologists do not routinely use neuraxial lipophilic opioids with CS parturients to prevent visceral pain.…”

Section: Discussionmentioning

confidence: 50%

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study

Huang

Hsieh

Wei

et al. 2015

Acta Anaesthesiologica Taiwanica

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Section: Discussionmentioning

confidence: 50%

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study

Huang

Hsieh

Wei

et al. 2015

Acta Anaesthesiologica Taiwanica

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“…In all four patients, after waiting for at least 15 (15)(16)(17)(18)(19)(20) min, spinal was converted to general anaesthesia before skin incision. 6 Three patients with inadequate block height did not require additional opioids in the immediate postoperative period with no or mild pain. One of these subjects undergoing her third caesarean section had adhesions and the duration of surgery was prolonged to 70 min.…”

Section: Resultsmentioning

confidence: 89%

An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section

Sng

Lim

Sia

2009

International Journal of Obstetric Anesthesia

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“…Indeed, a recent Cochrane review based on ten trials concluded that there are no differences in the efficacy of ESA vs SA for CD. 12 However, in recent studies, inadequate surgical anesthesia after conversion of ELA to ESA for CD necessitated conversion to GA in 2.5-20% of cases and provision of additional analgesia was even more frequent. [13][14][15][16][17][18][19] Only one underpowered study reported a conversion rate to GA of 0%.…”

Section: Discussionmentioning

confidence: 99%

Spinal anesthesia for intrapartum Cesarean delivery following epidural labor analgesia: a retrospective cohort study

Visser

Dijkstra

Albayrak

et al. 2009

Can J Anesth/J Can Anesth

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Purpose Failed conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum Cesarean delivery (CD) has been observed in clinical practice. However, spinal anesthesia (SA) in parturients experiencing failed conversion of ELA to ESA has been associated with an increased incidence of serious side effects. In this retrospective cohort analysis, we examined our routine clinical practice of removing the in situ epidural, rather than attempting to convert to ESA, prior to administering SA for intrapartum CD. Methods Hemodynamic data, frequencies of either high or total spinal block, and maternal and neonatal outcome data were gathered from the anesthesia records of all parturients at the Amphia Hospital, undergoing intrapartum CD between January 1, 2001 and May 1, 2005. Results Complete data were available for 693 patients (97.6%) of the 710 medical records that were identified. Of the 693 patients, 508 (73.3%) had no ELA and received SA, 128 patients (18.5%) received SA following epidural anesthesia for labor, 19 (2.7%) underwent conversion of ELA to ESA, and 38 (5.5%) received general anesthesia. When comparing both SA groups, no clinically relevant differences were observed regarding the incidence of total spinal block (0% in both groups) or high spinal block (0.2 vs 0.8%, P = 0.36). The number of hypotensive episodes, the total amount of ephedrine administered, and the Apgar scores recorded at 5 and 10 min were similar amongst groups. Conclusions The incidence of serious side effects associated with SA for intrapartum CD following ELA is low and not different compared to SA only. RésuméObjectif Dans la pratique clinique, l'e´chec du passage d'une analge´sie pe´ridurale pour le travail obste´trical a`une anesthe´sie pe´ridurale chirurgicale pour un accouchement par ce´sarienne a e´te´observe´. Cependant, la rachianesthe´sie re´alise´e chez les parturientes chez qui la conversion de la pe´ridurale avait e´choue´a e´te´associe´e à une incidence accrue d'effets secondaires graves. Dans cette analyse de cohorte re´trospective, nous avons examineń otre pratique clinique habituelle, qui consistait a`retirer le cathe´ter pe´ridural avant de re´aliser une rachianesthe´sie pour un accouchement par ce´sarienne, plutôt que de tenter une conversion de la pe´ridurale.

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Spinal versus epidural anaesthesia for caesarean section

Cited by 165 publications

References 29 publications

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study

An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section

Spinal anesthesia for intrapartum Cesarean delivery following epidural labor analgesia: a retrospective cohort study

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