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

Table 3

Usual next management step of respondents if a top up of an existing labor epidural for a category-two cesarean section resulted in an inadequate or failed sensory block.

Management	No objective sensory block ()	Bilateral T10 sensory block ()	Unilateral T6 sensory block ()	value (no objective sensory block vs bilateral T10 sensory block)	value (bilateral T10 sensory block vs unilateral T6 sensory block)
CSE	87 (12.3)	129 (18.5)	105 (15.2)	<0.001	0.10
General anesthesia	67 (9.4)	120 (17.2)	150 (21.7)	<0.001	0.03
Repeat epidural	2 (0.3)	11 (1.6)	13 (1.9)	0.01	0.66
Spinal	524 (73.9)	398 (56.9)	310 (44.9)	<0.001	<0.001
Withdraw in situ epidural catheter	6 (0.8)	10 (1.4)	65 (9.4)	0.30	<0.001
Other	23 (3.2)	31 (4.4)	48 (6.9)	0.25	0.04

Data are presented as number (%). CSE = combined spinal-epidural. In these scenarios, respondents were told to assume that neither further epidural top ups nor time would result in any change in the dermatomal level of the sensory block, and assessment of the parturient would demonstrate no undue concerns about the airway and no obvious difficulties in achieving a neuraxial technique if needed.