CHOOSING AN OPTIMAL METHOD FOR CONVERTING EPIDURAL ANALGESIA INTO ANESTHESIA DURING CESAREAN SECTION. LITERATURE REVIEW
Abstract
Introduction. One of the key components of active labor management is effective pain management. Various methods of neuraxial analgesia (spinal, epidural anesthesia and their modifications) are widely used for analgesic purposes in obstetric practice. So, the question of choosing subsequent anesthetic tactics arises, if woman in labor with an epidural catheter already installed for analgesia purposes needs cesarean section for emergency indications. Conversion of epidural analgesia to anesthesia is one of the options for further anesthetic management. Goal of study: to determine the optimal method of converting epidural analgesia to anesthesia during emergency surgical delivery, based on scientific literature analysis. Those studies are discussed, in which various options of neuraxial anesthesia for labor pain relief and conversion of epidural analgesia to anesthesia when surgical delivery is necessary are used. Materials and methods. Inclusion criteria: original works published in peer-reviewed journals, availability of publication’s full text. Exclusion criteria: lack of publication’s full text, clinical cases, editorial articles, lack of data necessary for analysis. Conversion of labor epidural analgesia to anesthesia for caesarean section is a common procedure. For this, various local anesthetics (lidocaine, bupivacaine, ropivacaine, levobupivacaine, prilocaine, etc.) and adjuvants (adrenaline, sodium bicarbonate, etc.) are used. The time of sensory block onset, duration of motor block, speed of woman’s recovery, hemodynamic stability and long-term obstetric and neonatal outcomes are used as efficiency criteriа of successful conversion. But no single local anesthetic or combination of local anesthetics has shown clear superior benefits. The following are recognized as risk factors for unsuccessful conversion with varying levels of reliability: age of woman in labor, woman’s height over 167 cm, gestational age (the higher it is, the greater is the likelihood of failure), lack of effective pain relief during labor, presence of breakthrough pain episodes, number of local anesthetic additional boluses, duration of labor analgesia, degree of caesarean section urgency and provision of anesthesia by a “non-obstetric” anesthesiologist. The risk of unsuccessful transition from epidural labor analgesia to anesthesia increases with the number of local anesthetic boluses administered during labor, degree of cesarean section urgency, duration of labor analgesia, and the provision of anesthesia by a “non-obstetric” anesthesiologist. Conclusion. To determine the optimal method of epidural analgesia conversion, choice of local anesthetic, its dosage, concentration and combinations of different drugs that do not have negative effect on the intrauterine state of fetus and newborn, further research is needed.
References
Абабков С.Г., Авдюнина И.А., Аверин А.П. и др. Анестезиология-реаниматология. М.: ГЭОТАР-Медиа; 2016.
Адамян Л.В., Артымук Н.В., Белокриницкая Т.Е., Куликов А.В., Овезов А.М., Петрухин В.А., Проценко Д.Н., Упрямова Е.Ю., Филиппов О.С., Шифман Е.М. Нейроаксиальные методы обезболивания родов. Клинические рекомендации. Анестезиология и реаниматология. 2018;(5):99110.
Александрович Ю.С., Муриева Э.А., Пшениснов К. В., Рязанова О.В. Особенности гормонального статуса матери и новорожденного ребенка при использовании длительной эпидуральной аналгезии в родах. Педиатр. СПб. 2011;2(4):51–55.
Антипин Э.Э., Уваров Д.Н., Недашковский Э.В., Кушев И.П. Эпидуральная анальгезия в первом периоде родов — есть ли альтернатива? Анестезиология и реаниматология. 2014;1:18–22.
Боженков К.А., Шифман Е.М., Густоварова Т.А. Эпидуральная анальгезия родов: взгляд сквозь десятилетия. Сибирское медицинское обозрение. 2020;2(122):5–12.
Иванов Д.О., Атласов В.О., Бобров С.А. и др. Руководство по перинатологии. СПб.: Информ-Навигатор; 2015.
Исмаилова Д.М., Додхоева М.Ф., Додоева К.С., Карабаев Д.И. Опыт применения длительной эпидуральной аналгезии и ее влияние на течение родов и перинатальные исходы. Вестник Авиценны. 2014;1(58):70–74.
Корячкин В.А., Заболотский Д.В. Место регионарных методов анестезии в хирургическом обезболивании. Медицина: теория и практика. 2018;3(4):65–69.
Куликов А.В., Шифман Е.М., Роненсон А.М., Овезов А.М. Методические рекомендации. Коррекция артериальной гипотонии при нейроаксиальной анестезии во время операции кесарево сечение. Регионарная анестезия и лечение острой боли. 2021;15(1):67–84.
Лахин Р.Е., Баялиева А.Ж., Ежевская А.А., Заболотский Д.В., Корячкин В.А., Куликов А.В., Овечкин А.М., Уваров Д.Н., Ульрих Г.Э., Филиппович Г.В., Шифман Е.М. Методические рекомендации министерства здравоохранения российской федерации по системной токсичности местных анестетиков. Регионарная анестезия и лечение острой боли. 2019;13(1-4):31–41.
Неймарк М.И., Иванова О.С. Обоснование целесообразности паравертебральной блокады для анальгезии самопроизвольных родов. Вестник анестезиологии и реаниматологии. 2018;15(3):26–33.
Проценко Д.Н., Ямщиков О.Н., Марченко А.П., Емельянов С.А., Марченко Р.А., Колобова Е.А. Комбинированная двухуровневая спинально-эпидуральная анестезия с фиксацией эпидурального катетера в подкожном канале с использованием модифицированной спинномозговой иглы. Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь». 2022;11(2):264–273.
Роды одноплодные, родоразрешение путем кесарева сечения. Клинические рекомендации. М.; 2021.
Рязанова О.В., Александрович Ю.С., Пшениснов К.В. Влияние анестезии при оперативном родоразрешении на неврологический статус новорожденного. Регионарная анестезия и лечение острой боли. 2012;6(3):38–43.
Рязанова О.В., Александрович Ю.С. Применение левобупивакаина для регионарной анестезии/анальгезии в акушерской и гинекологической практике. Обзор литературы. Анестезиология и реаниматология. 2018;63(1):16–20.
Рязанова О.В., Александрович Ю.С., Шифман Е.М., Пшениснов К.В., Резник В.А., Куликов А.В., Дробинская А.Н. Современные аспекты терапии маточных кровотечений при предлежании плаценты. Педиатр. 2016;7(3):117–127. DOI: 10.17816/PED73117-127.
Унжаков В.В., Нетесин Е.С., Горбачев В.И. Спорные вопросы системной токсичности местных анестетиков. Вестник анестезиологии и реаниматологии. 2020;17(1):46–51.
Упрямова Е.Ю., Шифман Е.М., Краснопольский В.И., Овезов А.М. Программированный интермиттирующий эпидуральный болюс (PIEB) для обезболивания самопроизвольных родов. Анестезиология и реаниматология. 2020;(4):69–77.
Шакиров Р.Т., Кинжалова С.В., Макаров Р.А. Нейроаксиальные методы обезболивания родов. Вестник анестезиологии и реаниматологии. 2018;15(5):65–73.
Anim-Somuah M., Smyth R.M., Cyna A.M., Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5(5):CD000331. DOI: 10.1002/14651858.CD000331.pub4.
Aragão F.F., Aragão P.W., Martins C.A., Leal KFCS., Ferraz Tobias A. Analgesia de parto no neuroeixo: uma revisão da literature. [Neuraxial labor analgesia: a literature review]. Braz J Anesthesiol. 2019;69(3):291–298.
Ashagrie H.E., Ahmed S.A., Melesse D.Y. The incidence and factors associated with failed spinal anesthesia among parturients underwent cesarean section, 2019: a prospective observational study. Int J Surg Open. 2020;24:47–51.
Bamgbade O.A., Khalaf W.M., Ajai O. et al. Obstetric anaesthesia outcome in obese and non-obese parturients undergoing caesarean delivery: an observational study. Int. J. Obstetr. Anesth., 2009;18(3):221–225.
Bauer M.E., Kountanis J.A., Tsen L.C., Greenfield M.L., Mhyre J.M. 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. 2012;21:294–309.
Bauer M.E., Mhyre J.M. Active management of labor epidural analgesia is the key to successful conversion of epidural analgesia to cesarean delivery anesthesia. Anesth Analg. 2016;123:1074–6.
Beckmann M., Calderbank S. Mode of anaesthetic for category 1 caesarean sections and neonatal outcomes. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2012;52:316–320. DOI: 10.1111/j.1479-828X.2012.01457.x
Cacciapuoti A., Castello G., Francesco A. Levobupivacaina, bupivacaina racemica e ropivacaina nel blocco del plesso brachiale. Minerva Anestesiol. 2002;68:599–605.
Campbell D.C., Tran T. Conversion of epidural labour analgesia to epidural anesthesia for intrapartum Cesarean delivery. Can J Anaesth. 2009;56:19–26.
Casati A., Putzu M. Bupivacaine, levobupivacaine and ropivacaine: are they clinically different? Best Pract Res Clin Anaesthesiol. 2005; 19:247–268.
Chandra S., Nugroho A.M., Agus H., Susilo A.P. How Low Can We Go? A Double-Blinded Randomized Controlled Trial to Compare Bupivacaine 5 mg and Bupivacaine 7.5 mg for Spinal Anesthesia in Cesarean Delivery in Indonesian Population. Anesth Pain Med. 2019;9(2):e91275.
Chao W.H., Cheng W.S., Hu L.M., Liao C.C. Risk factors for epidural anesthesia blockade failure in cesarean section: a retrospective study. BMC Anesthesiol. 2023;23(1):338.
Cheng C.R., Su T.H., Hung Y.C., Wang P.T. A comparative study of the safety and efficacy of 0.5% levobupivacaine and 0.5% bupivacaine for epidural anesthesia in subjects undergoing elective caesarean section. Acta Anaesthesiol Sin. 2002;40:13–20.
Cheng W., Xiong C., Li H., Wen J., Peng J., Wu S., Pan H., Chen L., Xia W., Zhao Y. Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study. BMC Anesthesiol. 2024;24(1):8.
Cohn J., Moaveni D., Sznol J., Ranasinghe J. Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period. Int J Obstet Anesth. 2016;25:30–6.
Desai N., Gardner A., Carvalho B. Labor Epidural Analgesia to Cesarean Section Anesthetic Conversion Failure: A National Survey. Anesthesiol Res Pract. 2019;2019:6381792. DOI: 10.1155/2019/6381792.
Desai N., Carvalho B. Conversion of labour epidural analgesia to surgical anaesthesia for emergency intrapartum Caesarean section. BJA Educ. 2020;20(1):26–31.
de Souza Soares E.C., Balki M., Downey K., Ye X.Y., Carvalho JCA. Assessment of sensory block during labour epidural analgesia: a prospective cohort study to determine the influence of the direction of testing. Can J Anaesth. 2022;69(6):750–755.
Dickson M.A., Jenkins J. Extension of epidural blockade for emergency caesarean section. Assessment of a bolus dose of bupivacaine 0.5% 10 ml following an infusion of 0.1% for analgesia in labour. Anaesthesia. 1994;49:636–638.
Ferrer L.E., Romero D.J., Vásquez O.I., Matute E.C., Van de Velde M. Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial. .Arch Gynecol Obstet. 2017;296(5):915–922.
Gambling D., Berkowitz J., Farrell T.R., Pue A., Shay D. A randomized controlled comparison of epidural analgesia and combined spinal-epidural analgesia in a private practice setting: pain scores during first and second stages of labor and at delivery. Anesth Analg. 2013;116(3):636–43.
Goffard P., Leloup R., Vercruysse Y., Fils J.F., Gautier P.E., Kapessidou Y. Comparison of equipotent doses of intrathecal hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for elective caesarean section: A prospective, randomised, controlled, two-centre clinical trial. Eur J Anaesthesiol. 2022;39(3):227–235.
Goring-Morris J., Russell I.F. A randomised comparison of 0.5% bupivacaine with a lidocaine/epinephrine/fentanyl mixture for epidural top-up for emergency caesarean section after “low dose” epidural for labour. Int J Obstet Anesth. 2006;15:109–114.
Grap S.M., Patel G.R., Huang J., Vaida S.J. Risk factors for labor epidural conversion failure requiring general anesthesia for cesarean delivery. J Anaesthesiol Clin Pharmacol. 2022;38(1):118–123. DOI: 10.4103/joacp.JOACP_192_20.
Guglielminotti J., Landau R., Daw J., Friedman A.M., Chihuri S., Li G. Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity. JAMA Netw Open. 2022;5(2):e220137.
Haller G., Stoelwinder J., Myles P.S., McNeil J. Quality and safety indicators in anesthesia. Anesthesiology. 2009;110(5):1158–1175.
Halliday L., Nelson S.M., Kearns R.J. Epidural analgesia in labor: A narrative review. Int J Gynaecol Obstet. 2022;159(2):356–364.
Halpern S.H., 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. British Journal of Anaesthesia. 2009;102:240–243. DOI: 10.1093/bja/aen352
Hassanin A.S., El-Shahawy H.F., Hussain S.H., Bahaa Eldin A.M., Elhawary M.M., Elbakery M., Elsafty MSE. Impact of interval between induction of spinal anesthesia to delivery on umbilical arterial cord ph of neonates delivered by elective cesarean section. BMC Pregnancy Childbirth. 2022;22(1):216.
Hattler J., Klimek M., Rossaint R., Heesen M. The Effect of Combined Spinal-Epidural Versus Epidural Analgesia in Laboring Women on Nonreassuring Fetal Heart Rate Tracings: Systematic Review and Meta-analysis. Anesth Analg. 2016;123(4):955–64.
Herrera-Gomez A., Garcia-Martinez O., Ramos-Torrecillas J., De Luna-Bertos E., Ruiz C., Ocana-Peinado F.M. Retrospective study of the association between epidural analgesia during labor and complications for the newborn. Midwifery 2015;31:613–616. DOI: 10.1016/j.midw.2015.02.013.
Herrera-Gómez A., Luna-Bertos E., Ramos-Torrecillas J. et al. The effect of epidural analgesia alone and in association with other variables on the risk of cesarean section. Biol Res Nurs. 2017;19(4):393–398.
Hillyard S.G., Bate T.E., Corcoran T.B., Paech M.J., O'Sullivan G. Extending epidural analgesia for emergency Caesarean section: a meta-analysis. Br J Anaesth. 2011;107(5):668–78.
Ismail S., Chugtai Sh., Hussain A. Incidence of cesarean section and analysis of risk factors for failed conversion of labor epidural to surgical anesthesia: A prospective, observational study in a tertiary care center. J Anaesthesiol Clin Pharmacol. 2015;31(4):535–541.
Jankovic D. Combined Spinal and Epidural Anesthesia (CSE). In: Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. 2015. https://doi.org/10.1007/978-3-319-05131-4_43.
Jian Z., Longqing R., Dayuan W., Fei J., Bo L., Gang Z., Siying Z., Yan G. Prolonged duration of epidural labour analgesia decreases the success rate of epidural anaesthesia for caesarean section. Ann Med. 2022;54(1):1112–1117.
Katakura Y., Nagamine Y., Goto T., Sumikura H. Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study. PLoS One. 2021;16(5):e0250596.
Kearns R.J., Lucas D.N. Neuraxial analgesia in labour and the foetus. Best Pract Res Clin Anaesthesiol. 2023;37(1):73–86.
Kim D.K. Anything that can go wrong, will go wrong: should a pre-existing epidural catheter be discarded for an intrapartum cesarean section? Korean J Anesthesiol. 2017;70(4):373. DOI: 10.4097/kjae.2017.70.4.373.
Kim H., Shin S.H., Ko M.J., Park Y.H., Lee K.H., Kim K.H. et al. Correlation Between Anthropometric Measurements and Sensory Block Level of Spinal Anesthesia for Cesarean Section. Anesth Pain Med. 2021;11(5):e118627.
Kinsella S.M. A prospective audit of regional anaesthesia failure in 5080 Caesarean sections. Anaesthesia. 2008;63:822–832.
Kinsella S.M., Winton A.L., Mushambi M.C. et al. Failed tracheal intubation during obstetric general anaesthesia: a literature review. International Journal of Obstetric Anesthesia. 2015;24(4):356–374.
Klimek M., Rossaint R., van de Velde M., Heesen M. Combined spinal-epidural vs. spinal anaesthesia for caesarean section: meta-analysis and trial-sequential analysis. Anaesthesia. 2018;73(7):875–888.
Koyyalamudi V., Sidhu G., Cornett E.M., Nguyen V., Labrie-Brown C., Fox C.J. et al. New labor pain treatment options. Curr Pain Headache Rep. 2016;20:11.
Lee S., Lew E., Lim Y., Sia A.T. Failure of augmentation of labor epidural analgesia for intrapartum cesarean delivery: a retrospective review. Anesth Analg. 2009;108(1):252–4.
Li P., Ma X., Han S., Kawagoe I., Ruetzler K., Lal A., Cao L., Duan R., Li J. Risk factors for failure of conversion from epidural labor analgesia to cesarean section anesthesia and general anesthesia incidence: an updated meta-analysis. J Matern Fetal Neonatal Med. 2023;36(2):2278020.
Liu P.L., Feldman H.S., Giasi R., Patterson M.K., Covino B.G. Comparative CNS toxicity of lidocaine, etidocaine, bupivacaine, and tetracaine in awake dogs following rapid intravenous administration. Anesth Analg. 1983;62:375–379.
Liu X., Zhang H., Zhang H., Guo M., Gao Y., Du C. Intermittent epidural bolus versus continuous epidural infusions for labor analgesia: a meta-analysis of randomized controlled trials. PLoS One. 2020;15(6):e0234353.
Maetzold E., Lambers D.S., Devaiah C.G., Habli M. The effect of combined spinal epidural versus epidural analgesia on fetal heart rate in laboring patients at risk for uteroplacental insufficiency. J Matern Fetal Neonatal Med. 2022;35(1):46–51.
Mankowitz S.K., Gonzalez Fiol A., Smiley R. Failure to extend epidural labor analgesia for cesarean delivery anesthesia: a focused review. Anesth Analg. 2016;123(5):1174–1180.
Moore A., el-Bahrawy A., Hatzakorzian R., Li-Pi-Shan W. Maternal Epidural Fentanyl Administered for Labor Analgesia Is Found in Neonatal Urine 24 Hours After Birth. Breastfeed Med. 2016;11(1):40–1.
Orbach-Zinger S., Friedman L., Avramovich A., Ilgiaeva N., Orvieto R., Sulkes J. et al. Risk factors for failure to extend labor epidural analgesia to epidural anesthesia for Cesarean section. Acta Anaesthesiol Scand. 2006;50:1014–1018.
Palmer E., Ciechanowicz S., Reeve A., Harris S., Wong D.J.N., Sultan P. Operating room-to-incision interval and neonatal outcome in emergency caesarean section: a retrospective 5-year cohort study. Anaesthesia. 2018;73(7):825–831.
Pan P.H., Bogard T.D., Owen M.D. Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries. International Journal of Obstetric Anesthesia. 2004;13(4):227–233.
Pandit J.J., Andrade J., Bogod D.G., Hitchman J.M., Jonker W.R., Lucas N. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. Br J Anaesth. 2014;113:549–59.
Panni M.K., Segal S. Local anesthetic requirements are greater in dystocia than in normal labor. Anesthesiology. 2003;98:957–63.
Poma S., Scudeller L., Verga C., Mirabile G., Gardella B., Broglia F. et al. Effects of combined spinal-epidural analgesia on first stage of labor: a cohort study. J Matern Fetal Neonatal Med. 2019;32:3559–3565.
Popham P., Buettner A., Mendola M. Anaesthesia for emergency caesarean section, 2000-2004, at the Royal Women's Hospital, Melbourne. Anaesth Intensive Care. 2007;35(1):74–9.
Powell M.F., Jarzombek K.W., Venhuizen K.J., Tubinis M.D., Morgan C.J., Frölich M.A. Comparing Bupivacaine, Lidocaine, and a Combination of Bupivacaine and Lidocaine for Labor Epidural Activation: A Prospective, Randomized, Double-Blind Study. Asian J Anesthesiol. 2019;57(2):55–60.
Punchuklang W., Nivatpumin P., Jintadawong T. Total failure of spinal anesthesia for cesarean delivery, associated factors, and outcomes: A retrospective case-control study. Medicine (Baltimore). 2022;101(27):e29813.
Purva M., Russell I., Kinsella M. Conversion from regional to general anaesthesia for caesarean section: are we meeting the standards? Anaesthesia. 2012;67(11):1278–9.
Raafat Elghamry M., Naguib T.M., Mansour R.F.. Anesthetic Conversion of Preexisting Labor Epidural Analgesia for Emergency Cesarean Section and Efficacy of Levobupivacaine with or Without Magnesium Sulphate: A Prospective Randomized Study. Anesth Pain Med. 2022;12(1):e121647.
Rahmati J., Shahriari M., Shahriari A., Nataj M., Shabani Z., Moodi V. Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia. AnesthPainMed. 2021;11(2):e113350.
Ramin S.M., Gambling D.R., Lucas M.J., Sharma S.K., Sidawi J.E., Leveno K.J. Randomized trial of epidural versus intravenous analgesia during labor. Obstet Gynecol. 1995;86(5):783–9.
Regan K.J., O’Sullivan G. The extension of epidural blockade for emergency caesarean section: a survey of current UK practice. Anaesthesia. 2008;63:136–142.
Polley L.S., Columb M.O., Naughton N.N., Wagner D.S., van de Ven C.J. Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. Anesthesiology. 1999;90:944–950.
Riazanova O.V., Alexandrovich Y.S., Guseva Y.V., Ioscovich A.M. A randomized comparison of low dose ropivacaine programmed intermittent epidural bolus with continuous epidural infusion for labour analgesia. Rom J Anaesth Intensive Care. 2019;26(1):25–30. DOI: 10.2478/rjaic-2019-0004.
Riley E.T., Papasin J. Epidural catheter function during labor predicts anesthetic efficacy for subsequent cesarean delivery. Int J Obstet Anesth. 2002;11:81–84.
Rimsza R.R., Perez W.M., Babbar S., O’Brien M., Vricella L.K. Time from neuraxial anesthesia placement to delivery is inversely proportional to umbilical arterial cord pH at scheduled cesarean delivery. Am J Obstet Gynecol. 2019;220(389):e1–9.
Rukewe A., Adebayo O.K., Fatiregun A.A. Failed obstetric spinal anesthesia in a Nigerian teaching hospital: incidence and risk factors. Anesth Analg. 2015;121:1301–5.
Sanders R.D., Mallory S., Lucas D.N., Chan T., Yeo S., Yentis S.M. Extending low-dose epidural analgesia for emergency caesarean section using ropivacaine 0.75%. Anaesthesia. 2004;59:988–992.
Shen C., Chen L., Yue C., Cheng J. Extending epidural analgesia for intrapartum cesarean section following epidural labor analgesia: a retrospective cohort study. J Matern Fetal Neonatal Med. 2022;35(6):1127–1133.
Šklebar I., Vrljičak M., Habek D., Šklebar T., Šakić L. Conversion rate of epidural analgesia to caesarean section regional or general anesthesia. Acta Clin Croat. 2022;61(Suppl 2):15–21.
Sng B.L., Pay L.L., Sia A.T. 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. 2008;36(5):659–64.
Tortosa J.C., Parry N.S., Mercier F.J., Mazoit J.X., Benhamou D. Efficacy of augmentation of epidural analgesia for Caesarean section. Br J Anaesth. 2003;91:532–535.
Wei Y., Wang Y., Zhao Y., Wu C., Liu H., Yang Z. High Dosage of Patient-Controlled Epidural Analgesia (PCEA) with Low Background Infusion during Labor: A Randomized Controlled Trial. J. Pers. Med. 2023;13.
Wiskott K., Jebrin R., Ioscovich D., Grisaru-Granovsky S., Tevet A., Shatalin D., Ioscovich A. General versus regional anesthesia for emergency cesarean delivery in a high-volume high-resource referral center: a retrospective cohort study. Anesthesia for Emergency Cesarean Delivery. 2020;27:6–10.
Wong C.A. General anesthesia is unacceptable for elective cesarean section. International Journal of Obstetric Anesthesia. 2010;19:209–217.
Zeng Y., Jiang T., Zheng Y.H., He W.R., Wang X.W., Wei H., Wang L., Liu Z.R., Zhang X.F., Yi C., Chen K.M. Evaluation efficacy and safety of epidural analgesia in second-trimester induced labor: A single-center, prospective, non-randomized, controlled study. Medicine (Baltimore). 2022;101(38):e30767.
Zhu S., Wei D., Zhang D., Jia F., Liu B., Zhang J. Prolonged epidural labor analgesia increases risks of epidural analgesia failure for conversion to cesarean section. Nan Fang Yi Ke Da Xue Xue Bao. 2022;42(8):1244–1249.
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