Labor Epidural Analgesia to Cesarean Section Anesthetic Conversion Failure: A National Survey

Table 2

Factors which influence management after a failed epidural top up of an existing labor epidural for a cesarean section.

Influencing factor	Respondents ()
Category of cesarean section	650 (91.5)
Dermatomal level of blockade	554 (78.0)
Assessment of airway	551 (77.6)
Risk of high or total spinal	513 (72.3)
Pattern of neuraxial block failure such as unequal or unilateral block	484 (68.2)
Perceived potential difficulty in achieving a neuraxial block	449 (63.2)
Length of time needed to establish a sensory block	433 (61.0)
Body mass index	431 (60.7)
Difficulties in predicting the correct intrathecal local anesthetic dose needed	410 (57.7)
Concentration and volume of local anesthetic used in epidural top up	386 (54.4)
Fasting status	237 (33.4)
Extension of sensory block possible if needed with a CSE or epidural technique	199 (28.0)
Risk of local anesthetic toxicity	179 (25.2)
Risk of the untested epidural catheter with a CSE technique	87 (12.3)
Postoperative analgesia	78 (11.0)
Other	29 (4.1)

Data are presented as number (%). CSE = combined spinal-epidural.