Our initial experience in providing pain relief during labor and delivery for 20 parturients using a 32-gauge continuous spinal microcatheter using 1% lidocaine is described. The technique significantly reduced the pain of labor, which was assessed as severe by 18 of the patients, and provided adequate perineal anesthesia for vaginal delivery with 18 patients indicating pain during delivery to be minimal. The major advantage of continuous spinal anesthesia is the ability to rapidly establish sensory anesthesia with the flexibility to reinject additional local anesthetic should a complete sensory or sensory and motor block be required for forceps or cesarean delivery. Technical difficulty was the main disadvantage with the use of the 32-gauge microcatheter. An inability to thread the catheter (two patients) through the 26-gauge spinal needle or kinking of the catheter (two patients) making injection impossible, and unintentional catheter removal (one patient) resulted in a 25% failure rate with this technique.
- spinal anesthesia
- vaginal delivery
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