Anesthesiologist Questions

“Epidural for L&D”

I have questions about epidural
1: How many fail attempts does anesthesiologist has before taking a different route?
2: With these failed attempts does the needle needs to replace?
3: How many pokes with epidural needle is to many?

Female | 34 years old
Complaint duration: 1 yr 11 mths
Medications: Levothyroxine
Conditions: Thyroid

3 Answers

Sometimes epidural could be difficult secondary to scoliosis, lordosis of the spine, after back surgeries etc. It might take a few pokes and several anesthesia providers to make it work. With applying sterile techniques multiple attempts are reasonable. Nowadays also ultrasonography is available to improve the success of the procedures. If all that fails and the situation is emergent or urgent for example for a cesarean section, general anesthesia should be a plan B.
Good question, but I don=E2=80=99t believe there is a direct answer. The number of attempts for epidural catheter placement is under the discretion of the anesthesiologist and patient=E2=80=99s willingness to proceed with subsequent efforts. Rare risks continue to be bleeding, nerve damage, infection, and dural puncture with headache.
There's no hard limit to how many attempts a person can make at any one particular location.. Generally I might personally try 3 or 4 times at 1 location before trying another. The needle will need to be replaced if it gets unusually bent or seems to be dulling. There's no set number of attempts that should or could be made before you stop. It's personal comfort level between the patient and the physician.

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