Failure to Extend Epidural Labor Analgesia for Cesarean Delivery Anesthesia: A Focused Review

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(Anesth Analg. 2016;123(5):1174–1180)Epidural conversion is the process by which cesarean delivery anesthesia is delivered to the patient via an existing in situ labor epidural catheter. It is not always successful. When failure occurs, it often necessitates induction of general anesthesia, which is associated with a higher risk of complications. The epidural conversion rate could potentially be used as a quality measure, and understanding factors associated with epidural conversion failure might help in preventing the need for another mode of surgical anesthesia. In this focused review, authors searched OvidSP and PubMed for studies discussing failed epidural conversion and reviewed factors associated with failure, as well as alternative anesthetic options.

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