Epidurals for Childbirth

Continuous infusion epidurals for obstetric analgesia.

Continuous infusion of local anaesthetic for epidural analgesia in obstetrics was first described in 1963. t However, this method of providing pain relief in labour did not become popular, probably because of the limitation of the mechanical pumps available at that time and also the tachyphylaxis associated with the use of lidocaine or mepivacaine. 2 Recently, continuous infusions have been des...

Blunt or sharp needles for transforaminal epidurals?

To the Editor: Derby et al (1) noted that in 2003 approximately half (14/29) of International Spinal Injection Society (ISIS) instructors and the majority (14/17) of poll respondents reported performing transforaminal epidural steroids injections. Do the authors have any data as to needle type (blunt vs sharp) used? If ISIS instructors persist in performing transforaminal injections with sharpt...

Obstetric epidurals and chronic adhesive arachnoiditis.

It has been suggested that obstetric epidurals lead to chronic adhesive arachnoiditis (CAA). CAA is a nebulous disease entity with much confusion over its symptomatology. This review outlines the pathological, clinical, and radiological features of the disease. The proposed diagnostic criteria for CAA are: back pain that increases on exertion, with or without leg pain; neurological abnormality ...

Pros and cons of epidurals with local for orthopaedic surgery

A randomised controlled trial using the Epidrum for labour epidurals.

The aim of our study was to determine if using the Epidrum to site epidurals improves success and reduces morbidity. Three hundred parturients requesting epidural analgesia for labour were enrolled. 150 subjects had their epidural sited using Epidrum and 150 using standard technique. We recorded subject demographics, operator experience, number of attempts, Accidental Dural Puncture rate, rate ...