The extension of epidural blockade for emergency Caesarean section: a survey of current UK practice

Anaesthesia
K J Regan, G O'Sullivan

Abstract

The conversion of epidural analgesia during labour to surgical anaesthesia for Caesarean section can have important medical and medicolegal implications. This survey sought to establish the current management for extending epidural blockade for emergency Caesarean section. A postal questionnaire was sent to the lead obstetric anaesthetist in all maternity units in the UK (n = 254). The response rate was 82% (n = 209). Of those surveyed, 68% (136) give the full dose of the local anaesthetic mixture in the delivery room, whilst 12.5% (25) initiate the top-up in the delivery room and give the remainder of the dose in theatre. Fifteen per cent (30) transfer the woman to theatre before commencing anaesthesia and 34% (68) give a test dose before the full anaesthetic dose. Guidelines for converting labour analgesia to anaesthesia for emergency Caesarean section were available in 64% (128) units. Bupivacaine 0.5% was the most commonly used agent, being used as the sole agent by 41.5% (81) units and in combination by a further 18% (36). Adrenaline was added to the chosen local anaesthetic by 30% (60) whilst 12% (24) added bicarbonate. In all, 13 combinations of local anaesthetics and adjuncts were used. The mode time to transfer the pat...Continue Reading

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Citations

Jun 6, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Anton VisserHenk J Vonsée
Oct 15, 2011·British Journal of Anaesthesia·S G HillyardG O'Sullivan
Apr 14, 2012·British Journal of Anaesthesia·S MalhotraN Lucas
Jan 1, 2009·Anesthesiology Research and Practice·Leinani Aiono-Le TagaloaBrendan Carvalho
May 13, 2009·Current Opinion in Anaesthesiology·Vegard Dahl, Ulrich J Spreng
Apr 16, 2011·Current Opinion in Anaesthesiology·Sarah Bern, Guy Weinberg
Oct 1, 2015·International Journal of Obstetric Anesthesia·K WildgaardM Ismaiel
Sep 14, 2010·International Journal of Obstetric Anesthesia·D N Lucas
Jan 16, 2010·Best Practice & Research. Clinical Obstetrics & Gynaecology·Alex T H SiaTerry U Tan
Oct 17, 2013·Anaesthesia·S DalayJ Greenwood
Jan 21, 2017·Journal of Clinical Epidemiology·Melina L WillsonUNKNOWN Guidelines International Network Implementation Working Group
Oct 20, 2019·Acta Anaesthesiologica Scandinavica·Elin Eb Bjornestad, Michael F Haney
Apr 16, 2019·Current Opinion in Anaesthesiology·Christina Massoth, Manuel Wenk
Apr 4, 2009·Current Opinion in Anaesthesiology·Michela Camorcia
Mar 25, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Chan ShenJing Cheng
Feb 16, 2013·British Journal of Hospital Medicine·Kate Sherratt, Kate Adams
Apr 25, 2021·International Journal of Obstetric Anesthesia·A L RichardsonD N Lucas
May 7, 2009·Current Opinion in Anaesthesiology

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