Troubleshooting Complicated Labor Epidural Analgesia: Improving Success And Reducing Complications
A 30 year-old parturient requested labor epidural analgesia (LEA). The catheter was initially threaded into the presumed epidural space, however, replacement was needed after multiple attempts to troubleshoot the catheter. Replacement was complicated by non-functioning, intravascular, and intrathecal catheter placements. LEA was ultimately aborted and the patient received intravenous analgesics for the duration of her labor with a spinal anesthetic for her eventual Cesarean delivery. Discussion will focus on the use of spinal ultrasonography during difficult neuraxial placement and the need for institutions to develop protocols for continuous spinal analgesia.
Tobes D, Haddad M, Kraemer J, Vahabzadeh C. Troubleshooting complicated labor epidural analgesia: Improving success and reducing complications. Abstract presented at: Anesthesiology 2019. American Society of Anesthesiology, Orlando, FL; 2019 October 19-23.