Conversion of epidural analgesia to anesthesia for cesarean section

• Main Authors: Yevhenii Grizhimalsky, Andrii Harha, Yevhenii Sulimenko
• Format: Article
• Language: English
• Published: Interdisciplinary Academy of Pain Medicine 2021-04-01
• Series: Медицина болю
• Subjects: cesarean section; epidural anaesthesia; labour pain relief; conversion
• Online Access: https://painmedicine.org.ua/index.php/pnmdcn/article/view/245

The frequency of cesarean sections is increasing from year to year, and the choice of optimal anesthetic management is important. Regional anaesthesia is the anaesthesia of choice for the cesarean section because it reduces maternal and neonatal risks. If an epidural pain relief of labor is performed, then this epidural catheter can be successfully used for conversion to epidural anaesthesia. The choice of drug for conversion depends on the degree of urgency; the highest rate of onset of anesthesia is shown by lidocaine with adjuvants (fentanyl, sodium bicarbonate). Conversion failure occurs in 0–21% of cases; the main risk factors for conversion failure are inadequate epidural analgesia and patient height. The management of failed conversion depends on the category of urgency and other factors and may include spinal, combined spinal-epidural, or general anesthesia