This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lee, S. Articles by Sia, A. T. Search for Related Content PubMed PubMed Citation Articles by Lee, S. Articles by Sia, A. T. Related Collections Obstetrics Outcomes Regional Anesthesia

---

OBSTETRIC ANESTHESIOLOGY

Failure of Augmentation of Labor Epidural Analgesia for Intrapartum Cesarean Delivery: A Retrospective Review

From the Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore.

Address correspondence to Eileen Lew, MMed, Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, 100, Bukit Timah Rd., Singapore 229899, Republic of Singapore. Address e-mail to eileen.lew{at}kkh.com.sg.

Abstract

In this study, we aimed to identify the incidence and predictive factors associated with failed labor epidural augmentation for cesarean delivery. Data of parturients, who had received neuraxial labor analgesia and who subsequently required intrapartum cesarean delivery during an 18-mo period, were retrospectively studied. Predictors associated with failure of extension of epidural analgesia in the presence of adequate time for onset of epidural anesthesia were identified by univariate logistic regression. Of the 1025 parturients, 1.7% had failed epidural extension. Predictors of failed epidural anesthesia included initiation of labor analgesia with plain epidural technique (compared to combined spinal-epidural) (P = 0.001), 2 episodes of breakthrough pain during labor (P < 0.001) and prolonged duration of neuraxial labor analgesia (P = 0.02).