• Sharon Orbach-Zinger, Leonid A Eidelman, A WazwazSusanSDepartment of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel., Avi Ben-Haroush, Shlomo Fireman, Michael Heesen, Eran Hadar, Carolyn F Weiniger, and Evgeniya Kornilov.
• Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
• Acta Anaesthesiol Scand. 2021 Mar 1; 65 (3): 397-403.

BackgroundThere are cases where epidural analgesia is initially effective but subsequently fails and needs to be resited. We evaluated the rate of normal vaginal delivery and operative delivery among parturients who had resited epidurals compared to parturients with epidurals that were not resited.MethodsA retrospective electronic medical review of parturients with a singleton gestation attempting normal vaginal delivery under epidural analgesia between the years 2012-2016 was conducted. Resited epidurals were defined as epidurals that were considered effective but subsequently removed and reinserted. For each resited epidural, two previous and two consecutive deliveries of parturients with normally functioning epidural catheter inserted by the same anesthesiologist were matched controls (non-resited epidurals).ResultsThere were 35,984 attempted vaginal deliveries with 118 resited epidurals and 472 non-resited epidurals. When adjusted for nulliparity, oxytocin administration, sex and weight of the baby, and maternal BMI, labor epidural catheter replacement was not associated with need for instrumental or caesarean delivery, (OR 1.5, 95% CI 0.91-2.49, P = .11).ConclusionsNeed for labor epidural catheter replacement does not appear to be associated with need for operative delivery based on this single-centre cohort analysis.© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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