JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Cherayil, G.
Right arrow Articles by Tsen, L. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cherayil, G.
Right arrow Articles by Tsen, L. C.
Related Collections
Right arrow Obstetrics
Right arrow Regional Anesthesia

Anesth Analg 2002;94:1589-1592
© 2002 International Anesthesia Research Society

OBSTETRIC ANESTHESIA

Central Neuraxial Blockade Promotes External Cephalic Version Success After a Failed Attempt

Gerald Cherayil, MD*, Bruce Feinberg, MD{dagger}, Julian Robinson, MD{dagger}, and Lawrence C. Tsen, MD*

Departments of Anesthesiology, *Perioperative & Pain Medicine, and {dagger}Obstetrics, Gynecology & Reproductive Biology, Harvard Medical School, Brigham and Women’s Hospital, CWN-L1, Boston, Massachusetts

Address correspondence and reprint requests to Lawrence C. Tsen, MD, Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham and Women’s Hospital, CWN-L1, Boston, Massachusetts 02115. Address e-mail to ltsen{at}zeus.bwh.harvard.edu

External cephalic version (ECV) has been successfully used to decrease the fetal and maternal morbidity and costs of cesarean delivery. As there are limited data regarding the use of central neuraxial blockade in the setting of previously failed ECV attempts, we sought to evaluate the efficacy and safety of spinal and epidural anesthesia in this setting. A retrospective review of all ECV attempts performed by a single experienced obstetrician between 1995 and 1999 was conducted. Standardized tocolytic and anesthetic regimens were used. A total of 77 patients underwent ECV attempts; of these, 37 (48%) were unsuccessful, 15 of which consented to further attempts with anesthesia. Neuraxial anesthesia was associated with frequent ECV success in both multiparous 4/4 (100%) and nulliparous 9/11 (82%) parturients. Overall 5/6 (83%) and 8/9 (89%) (P = NS) ECV attempts were successful with spinal and epidural anesthesia, respectively, with 2/5 (40%) and 6/8 (75%) (P = NS) resulting in vaginal deliveries. One successful ECV in the epidural group had an urgent cesarean delivery for persistent fetal bradycardia with good neonatal and maternal outcomes. We conclude central neuraxial anesthesia promotes successful ECV after previously failed ECV attempts.

IMPLICATIONS: Our retrospective analysis of central neuraxial techniques, both epidural and spinal anesthesia, noted a significant success rate in the setting of previously failed external cephalic version attempts.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.