Urgent Cesarean Section Following Discovery Of Failed Epidural; What, Why, And How?

Document Type

Conference Proceeding - Restricted Access

Publication Date



A healthy 28-year-old G1P0 parturient at 40 weeks gestation presented in active stage of labor. The patient received combined spinal-epidural anesthesia, achieving pain relief for several hours but subsequently experiencing discomfort. An epidural bolus was administered without improvement. Within minutes, fetal heart decelerations resulted in request for urgent cesarean section. Consideration was given to bolusing the existing epidural, replacing the epidural, spinal anesthesia, and general endotracheal anesthesia; ultimately the practitioner chose to replace the epidural and proceeded to uncomplicated cesarean delivery. This presentation will examine management of the failed labor epidural in the setting of urgent conversion to cesarean delivery.


American Society of Anesthesiology, Anesthesiology 2019. Orlando, FL. October 19-23, 2019. Abstract.