Prior Anesthetic Problems

  • Susan Cosgrove
  • Richard SmileyEmail author


Many parturients present for antenatal anesthesia consultation due to a history of anesthetic complications. This section will discuss some of the more common reasons for presentation including epidural failure, post-dural puncture headache, allergic reaction, malignant hyperthermia, pseudocholinesterase deficiency and vasovagal episodes.


Accidental dural puncture Post-dural puncture headache Failed epidural Anesthetic allergy Anaphylaxis Pseudocholinesterase Vasovagal syncope 


  1. 1.
    Eappen S, Blinn A, Segal S. Incidence of epidural catheter replacement in parturients: a retrospective chart review. Int J Obstet Anesth. 1998;7:220–5.CrossRefGoogle Scholar
  2. 2.
    Pan PH, Bogard TD, Owen MD. Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries. Int J Obstet Anesth. 2004;13:227–33.CrossRefGoogle Scholar
  3. 3.
    Bauchat JR, McCarthy RJ, Koski TR, Wong CA. Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study. Anesth Analg. 2015;121:981–7.CrossRefGoogle Scholar
  4. 4.
    Kinsella SM. A prospective audit of regional anaesthesia failure in 5080 caesarean sections. Anaesthesia. 2008;63:822–32.CrossRefGoogle Scholar
  5. 5.
    Halpern SH, Soliman A, Yee J, Angle P, Ioscovich A. Conversion of epidural labour analgesia to anaesthesia for caesarean section: a prospective study of the incidence and determinants of failure. Br J Anaesth. 2009;102:240–3.CrossRefGoogle Scholar
  6. 6.
    Mankowitz SK, Gonzalez Fiol A, Smiley R. Failure to extend epidural labor analgesia for cesarean delivery anesthesia: a focused review. Anesth Analg. 2016;123:1174–80.CrossRefGoogle Scholar
  7. 7.
    Beilin Y, Bernstein HH, Zucker-Pinchoff B. The optimal distance that a multiorifice epidural catheter should be threaded into the epidural space. Anesth Analg. 1995;81:301–4.PubMedGoogle Scholar
  8. 8.
    Gurrieri C, Weingarten TN, Martin DP, Babovic N, Narr BJ, Sprung J, Volcheck GW. Allergic reactions during anesthesia at a large United States referral center. Anesth Analg. 2011;113:1202–12.CrossRefGoogle Scholar
  9. 9.
    Mulla ZD, Ebrahim MS, Gonzalez JL. Anaphylaxis in the obstetric patient: analysis of a statewide hospital discharge database. Ann Allergy Asthma Immunol. 2010;104:55–9.CrossRefGoogle Scholar
  10. 10.
    Asserhoj LL, Mosbech H, Kroigaard M, Garvey LH. No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanutdagger. Br J Anaesth. 2016;116:77–82.CrossRefGoogle Scholar
  11. 11.
    Mertes PM, Lambert M, Gueant-Rodriguez RM, Aimone-Gastin I, Mouton-Faivre C, Moneret-Vautrin DA, Gueant JL, Malinovsky JM, Demoly P. Perioperative anaphylaxis. Immunol Allergy Clin N Am. 2009;29:429–51.CrossRefGoogle Scholar
  12. 12.
    Baraka A, Sfeir S. Anaphylactic cardiac arrest in a parturient. Response of the newborn. JAMA. 1980;243:1745–6.CrossRefGoogle Scholar
  13. 13.
    Balestrieri PJ, Ferguson JE 2nd. Management of a parturient with a history of local anesthetic allergy. Anesth Analg. 2003;96:1489–90.CrossRefGoogle Scholar
  14. 14.
    Vallejo MC, Mandell GL, Sabo DP, Ramanathan S. Postdural puncture headache: a randomized comparison of five spinal needles in obstetric patients. Anesth Analg. 2000;91(4):916–20.CrossRefGoogle Scholar
  15. 15.
    Van de Velde M, Schepers R, Berends N, Vandermeersch E, De Buck F. Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric anaesthesia department. Int J Obstet Anesth. 2008;17(4):329–35.CrossRefGoogle Scholar
  16. 16.
    Scavone BM, Wong CA, Sullivan JT, Yaghmour E. Efficacy of a prophylactic epidural blood patch in preventing post dural puncture headache in parturients after inadvertent dural puncture. Anesthesiology. 2004;101:1422–7.CrossRefGoogle Scholar
  17. 17.
    Norris MC, Grieco WM, Borkowski M, Leighton BL, Arkoosh VA, Huffnagle HJ, et al. Complications of labor analgesia: epidural versus combined spinal epidural techniques. Anesth Analg. 1994;79(3):529.CrossRefGoogle Scholar
  18. 18.
    Sachs A, Smiley R. Post-dural puncture headache: the worst common complication in obstetric anesthesia. Semin Perinatol. 2014;38(6):386–94.CrossRefGoogle Scholar
  19. 19.
    Pantuck E. Plasma cholinesterase: gene and variations. Anesth Analg. 1993;77:380–6.CrossRefGoogle Scholar
  20. 20.
    Ostergaard D, Jensen FS, Jensen E, Skovgaard LT, Viby-Mogensen J. Mivacurium induced neuromuscular blockade (NMB) in patients heterozygous for the atypical gene for plasma cholinesterase. Acta Anaesthesiol Scand. 1993;37:314–8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Washington University School of Medicine in St LouisSt. LouisUSA
  2. 2.Department of AnesthesiologyColumbia University College of Physicians and SurgeonsNew YorkUSA

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