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- Title
The labour epidural: troubleshooting.
- Authors
Kingsley, Charlotte; McGlennan, Alan
- Abstract
* Labour epidural failure rate is 9-12% and can be multifactorial * Poor insertion technique (multiple needle passes), needle mal-placement (off midline), inadequate loading dose and/or infusion rate, catheter migration and rapid labour progression are the commonest causes of labour epidural failure * Anatomical factors such as previous spinal surgery can affect placement and subsequent epidural failure * Immediate identification of intrathecal and intravascular catheters are vital * Continuous active management of epidurals is required, with a low threshold to replace inadequately functioning catheters.
- Subjects
ANALGESICS; ANESTHESIA in obstetrics; DOSE-effect relationship in pharmacology; LABOR (Obstetrics); MATERNAL health services; MEDICAL quality control; MEDICAL errors; NARCOTICS; NURSE anesthetists; EPIDURAL anesthesia; REOPERATION; JOB performance; TREATMENT effectiveness; EPIDURAL analgesia; EPIDURAL injections; EPIDURAL space; PREGNANCY
- Publication
Update in Anaesthesia, 2019, Vol 34, p30
- ISSN
1353-4882
- Publication type
Article