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Extension of Epidural Block for Cesarean Section

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Epidural Labor Analgesia
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Abstract

Due to substantial differences in resources and traditions, the rate of cesarean deliveries varies widely from country to country. Worldwide, the rate of cesarean section (CS) is estimated to be approximately 15 %, with South America having the highest rates (29 %) and Africa the lowest with only 3.5 %. The average CS rate in Europe in 2007 was 19 %, highest in Italy (36 %) and Portugal (30.2 %) and lowest in Serbia, Montenegro, and Moldavia (6.2–8 %) [1, 2].

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References

  1. Betran AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P et al (2007) Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol 21(2):98–113

    Article  PubMed  Google Scholar 

  2. World Health Orginazation. European Health for all database. 23-4-2014. Ref Type: Internet Communication

    Google Scholar 

  3. Norwegian Institute of Public Health. Pregnancy, birth and infancy. 8-4-2014. Ref Type: Internet Communication

    Google Scholar 

  4. Kinsella SM (2008) A prospective audit of regional anaesthesia failure in 5080 Caesarean sections. Anaesthesia 63(8):822–832

    Article  CAS  PubMed  Google Scholar 

  5. Hueston WJ (1994) Development of a cesarean delivery risk score. Obstet Gynecol 84(6):965–968

    CAS  PubMed  Google Scholar 

  6. Schuit E, Kwee A, Westerhuis ME, Van Dessel HJ, Graziosi GC, Van Lith JM et al (2012) A clinical prediction model to assess the risk of operative delivery. BJOG 119(8):915–923

    Article  CAS  PubMed  Google Scholar 

  7. NHS Maternity Statistics – England, 2012–2013 (2014) http://www.hscic.gov.uk/searchcatalogue?productid¼13418&q¼caesarean&topics¼0%2fHospital+care&sort¼Relevance&size¼10&page¼1#top. 8-4-2014. Ref Type: Internet Communication

  8. Essex HN, Green J, Baston H, Pickett KE (2013) Which women are at an increased risk of a caesarean section or an instrumental vaginal birth in the UK: an exploration within the Millennium Cohort Study. BJOG 120(6):732–743

    Article  CAS  PubMed  Google Scholar 

  9. Banerjee A, Hollinshead J, Williams E (2001) Delivery by caesarean section. Increased numbers of caesareans do not match diagnoses of fetal distress. BMJ 323(7318):930–931

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Costantine MM, Saade GR (2012) The first cesarean: role of “fetal distress” diagnosis. Semin Perinatol 36(5):379–383

    Article  PubMed  Google Scholar 

  11. Tuffnell DJ, Wilkinson K, Beresford N (2001) Interval between decision and delivery by caesarean section—are current standards achievable? Observational case series. BMJ 322(7298):1330–1333

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Wee HY, Quek SC (2001) Delivery by caesarean section. Effective system of mobilisation is used in Singapore. BMJ 323(7318):931

    CAS  Google Scholar 

  13. Colvin JR, Peden CJ (2006) Raising the Standard: a compendium of audit recipes for continuous quality improvement in anaesthesia. http://www.rcoa.ac.uk/2012(3):1-402. Available from: http://www.rcoa.ac.uk/system/files/CSQ-ARB-2012_1.pdf

  14. Caesarean section (2012) http://publications.nice.org.uk/caesarean-section-cg132

  15. Leung TY, Lao TT (2013) Timing of caesarean section according to urgency. Best Pract Res Clin Obstet Gynaecol 27(2):251–267

    Article  PubMed  Google Scholar 

  16. American Society of Anesthesiologists Task Force on Obstetric Anesthesia (2007) Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology 106(4):843

    Article  Google Scholar 

  17. Popham P, Buettner A, Mendola M (2007) Anaesthesia for emergency caesarean section, 2000–2004, at the Royal Women’s Hospital, Melbourne. Anaesth Intensive Care 35(1):74–79

    CAS  PubMed  Google Scholar 

  18. Lim Y, Shah MK, Tan HM (2005) Evaluation of surgical and anaesthesia response times for crash caesarean sections-An audit of a Singapore hospital. Ann Acad Med Singapore 34(10):606

    CAS  PubMed  Google Scholar 

  19. Regan KJ, O’Sullivan G (2008) The extension of epidural blockade for emergency Caesarean section: a survey of current UK practice. Anaesthesia 63(2):136–142

    Article  CAS  PubMed  Google Scholar 

  20. Lam DTC, Ngan Kee WD, Khaw KS (2001) Extension of epidural blockade in labour for emergency Caesarean section using 2% lidocaine with epinephrine and fentanyl, with or without alkalinisation. Anaesthesia 56(8):777–798

    Article  Google Scholar 

  21. Capogna G, Celleno D, Costantino P, Muratori F, Sebastiani M, Baldassini M (1993) Alkalinization improves the quality of lidocaine-fentanyl epidural anaesthesia for caesarean section. Can J Anaesth 40(5):425–430

    Article  CAS  PubMed  Google Scholar 

  22. Chassard D, Berrada K, Bouletreau P (1996) Alkalinization of local anesthetics: theoretically justified but clinically useless. Can J Anaesth 43(4):384–393

    Article  CAS  PubMed  Google Scholar 

  23. Niemi G (2005) Advantages and disadvantages of adrenaline in regional anaesthesia. Best Pract Res Clin Anaesthesiol 19(2):229–245

    Article  CAS  PubMed  Google Scholar 

  24. Dahl V, Hagen I, Koss KS, Nordentoft J, Raeder JC (1999) Bupivacaine 2.5 mg/ml versus bupivacaine 0.625 mg/ml and sufentanil l microg/ml with or without epinephrine 1 microg/ml for epidural analgesia in labour. Int J Obstet Anesth 8(3):155–160

    Article  CAS  PubMed  Google Scholar 

  25. Malhotra S, Yentis SM (2007) Extending low-dose epidural analgesia in labour for emergency Caesarean section – a comparison of levobupivacaine with or without fentanyl. Anaesthesia 62(7):667–671

    Article  CAS  PubMed  Google Scholar 

  26. Torvaldsen S, Roberts CL, Simpson JM, Thompson JF, Ellwood DA (2006) Intrapartum epidural analgesia and breastfeeding: a prospective cohort study. Int Breastfeed J 1:24

    Article  PubMed Central  PubMed  Google Scholar 

  27. Beilin Y, Bodian CA, Weiser J, Hossain S, Arnold I, Feierman DE et al (2005) Effect of labor epidural analgesia with and without fentanyl on infant breast-feeding: a prospective, randomized, double-blind study. Anesthesiology 103(6):1211–1217

    Article  CAS  PubMed  Google Scholar 

  28. Reynolds F (2010) The effects of maternal labour analgesia on the fetus. Best Pract Res Clin Obstet Gynaecol 24(3):289–302

    Article  PubMed  Google Scholar 

  29. Allam J, Malhotra S, Hemingway C, Yentis SM (2008) Epidural lidocaine-bicarbonate-adrenaline vs levobupivacaine for emergency Caesarean section: a randomised controlled trial. Anaesthesia 63(3):243–249

    Article  CAS  PubMed  Google Scholar 

  30. Russell IF (2004) A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section. Int J Obstet Anesth 13(3):146–152

    Article  CAS  PubMed  Google Scholar 

  31. Balaji P, Dhillon P, Russell IF (2009) Low-dose epidural top up for emergency caesarean delivery: a randomised comparison of levobupivacaine versus lidocaine/epinephrine/fentanyl. Int J Obstet Anesth 18(4):335–341

    Article  CAS  PubMed  Google Scholar 

  32. Bjørnestad E, Iversen O, Raeder J (2006) Similar onset time of 2-chloroprocaine and lidocaine + epinephrine for epidural anesthesia for elective Cesarean section. Acta Anaesthesiol Scand 50(3):358–363

    Article  PubMed  Google Scholar 

  33. Hemingway C, Woolnough M, Richards N, Yentis S (2008) Preparation times for pH-adjusted lidocaine/adrenaline epidural top-up mixture. Int J Obst Anesth 17(Suppl):S30

    Google Scholar 

  34. Sanders RD, Mallory S, Lucas DN, Chan T, Yeo S, Yentis SM (2004) Extending low-dose epidural analgesia for emergency Caesarean section using ropivacaine 0.75%. Anaesthesia 59(10):988–992

    Article  CAS  PubMed  Google Scholar 

  35. Sng BL, Pay LL, Sia AT (2008) Comparison of 2% lignocaine with adrenaline and fentanyl, 0.75% ropivacaine and 0.5% levobupivacaine for extension of epidural analgesia for urgent caesarean section after low dose epidural infusion during labour. Anaesth Intensive Care 36(5):659–664

    CAS  PubMed  Google Scholar 

  36. Hillyard SG, Bate TE, Corcoran TB, Paech MJ, O’Sullivan G (2011) Extending epidural analgesia for emergency Caesarean section: a meta-analysis. Br J Anaesth 107(5):668–678

    Article  CAS  PubMed  Google Scholar 

  37. Russell IF (2001) Editorial: assessing the block for caesarean section. Int J Obstet Anesth 10(2):83–85

    Article  CAS  PubMed  Google Scholar 

  38. Inadequate Regional Block (2011) http://www.oaaanaes.ac.uk/content.asp?ContentID=411. Ref Type: Internet Communication

  39. Campbell DC, Tran T (2009) Conversion of epidural labour analgesia to epidural anesthesia for intrapartum Cesarean delivery. Can J Anaesth 56(1):19–26

    Article  PubMed  Google Scholar 

  40. Bauer ME, Kountanis JA, Tsen LC, Greenfield ML, Mhyre JM (2012) Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials. Int J Obstet Anesth 21(4):294–309

    Article  CAS  PubMed  Google Scholar 

  41. Furst SR, Reisner LS (1995) Risk of high spinal anesthesia following failed epidural block for cesarean delivery. J Clin Anesth 7(1):71–74

    Article  CAS  PubMed  Google Scholar 

  42. Wilson MJA (2005) When using spinal anaesthesia for caesarean section after the epidural has failed, the normal dose of spinal anaesthetic should be used. Int J Obstet Anesth 14(1):53–55

    Article  CAS  PubMed  Google Scholar 

  43. Stocks GM (2005) When using spinal anaesthesia for caesarean section after the epidural hasfailed, the normal dose of spinal anaesthetic should be used. Int J Obstet Anesth 14:55–57

    Article  CAS  PubMed  Google Scholar 

  44. Carvalho B, Durbin M, Drover DR, Cohen SE, Ginosar Y, Riley ET (2005) The ED50 and ED95 of intrathecal isobaric bupivacaine with opioids for cesarean delivery. Anesthesiology 103(3):606–612

    Article  CAS  PubMed  Google Scholar 

  45. Leo S, Sng BL, Lim Y, Sia AT (2009) A randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery. Anesth Analg 109(5):1600–1605

    Article  CAS  PubMed  Google Scholar 

  46. Langesaeter E, Rosseland LA, Stubhaug A (2008) Continuous invasive blood pressure and cardiac output monitoring during cesarean delivery: a randomized, double-blind comparison of low-dose versus high-dose spinal anesthesia with intravenous phenylephrine or placebo infusion. Anesthesiology 109(5):856–863

    Article  CAS  PubMed  Google Scholar 

  47. Vercauteren MP, Coppejans HC, Hoffmann VL, Saldien V, Adriaensen HA (1998) Small-dose hyperbaric versus plain bupivacaine during spinal anesthesia for cesarean section. Anesth Analg 86(5):989–993

    CAS  PubMed  Google Scholar 

  48. Ben-David B, Miller G, Gavriel R, Gurevitch A (2000) Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 25(3):235–239

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Vegard Dahl .

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Dahl, V., Rosseland, L.A. (2015). Extension of Epidural Block for Cesarean Section. In: Capogna, G. (eds) Epidural Labor Analgesia. Springer, Cham. https://doi.org/10.1007/978-3-319-13890-9_14

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  • DOI: https://doi.org/10.1007/978-3-319-13890-9_14

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