Mayo Clinic
As the dural puncture epidural (DPE) is increasing in popularity for labor analgesia, it is important to understand how it impacts outcomes in parturients. Prior studies have found epidural catheters placed via the combined-spinal epidural technique have greater success at surgical conversion for cesarean delivery than catheters placed via traditional techniques. The investigators aim to determine if epidural catheters placed by a DPE technique will also have an increased successful conversion for surgical anesthesia by conducting a retrospective review of all CD during the study period. If an association is found, this could be another benefit of DPE for labor analgesia.
Electronic medical records will be searched for all intrapartum cesarean deliveries performed from February 1, 2017 through May 30, 2021 (Mayo Clinic) and from January 1, 2022 to December 31, 2022 (BC Women's Hospital). From this list, patients that had cesarean delivery with an epidural catheter will be identified and split into three groups based on the type of neuraxial block listed in the block document of the patient's medical record: Group 1 - Dural puncture epidural Group 2 - Epidural Group 3 - Combined spinal-epidural Failure of epidural catheter conversion to surgical anesthesia at…
Inclusion Criteria: 1. Women with neuraxial labor analgesia (CSE, DPE, or Epidural) who have an intrapartum cesarean delivery 2. Singleton gestation Exclusion Criteria: 1. No local anesthetic given in epidural for cesarean delivery (in emergency situation) 2. Inadvertent dural puncture
Traditional epidural catheter placement
Epidural catheters placed via DPE technique
Epidural catheters placed via CSE technique
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