The effect of intrathecal analgesia on the success of external cephalic version

David J. Birnbach, Jay Matut, Deborah J. Stein, Joanne Campagnuolo, Calin Drimbarean, Amos Grunebaum, Maxine M. Kuroda, Daniel M. Thys

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

External cephalic version (ECV), the procedure whereby a fetus in the breech position is converted to vertex, is often performed to avoid an operative delivery. Potential benefits of epidural and spinal anesthesia for this procedure are controversial. Several previous studies have evaluated the use of epidural anesthesia with varying results. We sought to determine whether analgesia produced by subarachnoid sufentanil would safely improve the success of ECV. Patients who received subarachnoid analgesia (n = 20) were compared with those who did not (n = 15) in regard to success of ECV, level of pain during ECV, and satisfaction. ECV was successful in 21 patients (60%), with more frequent success in women who received spinal analgesia as compared with those who did not (80% vs 33%, respectively; P = 0.005). Patients who received spinals also reported smaller pain scores and were more satisfied with ECV. None of the women who received spinal analgesia developed a postdural puncture headache, and the only case of fetal bradycardia occurred in a patient who did not receive spinal analgesia. More profound patient comfort after spinal analgesia may have permitted greater manipulation of the abdomen during ECV, thus improving success rates of ECV without increasing risk.

Original languageEnglish (US)
Pages (from-to)410-413
Number of pages4
JournalAnesthesia and analgesia
Volume93
Issue number2
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Birnbach, D. J., Matut, J., Stein, D. J., Campagnuolo, J., Drimbarean, C., Grunebaum, A., Kuroda, M. M., & Thys, D. M. (2001). The effect of intrathecal analgesia on the success of external cephalic version. Anesthesia and analgesia, 93(2), 410-413. https://doi.org/10.1213/00000539-200108000-00035