Anaes Vivas · Neuraxial anaesthesia
Epidural for labour — clinical procedure viva
A clinical viva on labour epidural analgesia: consent and coagulation check, the loss-of-resistance siting and catheter, the test dose and incremental top-up or infusion, and the complications (wet tap with pneumorrhachis, epidural-related fever, haematoma).
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Prompt
A healthy primigravida in established labour at 4 cm requests an epidural. Take me through how you would provide labour epidural analgesia, including the technique, the management of the block, and the complications you would discuss.
Stimulus
A healthy primigravida in established labour at 4 cm requests an epidural. Take me through how you would provide labour epidural analgesia, including the technique, the management of the block, and the complications you would discuss[2][1].
References5ShowHide
- [1]Zhang M, Zhang L, Chen D, et al. Epidural-related maternal fever and metabolomic changes: a pilot exploratory study. Int J Obstet Anesth, 2026.PMID 42361496
- [2]Kutlesić M, Kutlesić R [Epidural analgesia in labor: specific characteristics, dilemmas and controversies]. Med Pregl, 2012.PMID 23214341
- [3]Greenspon NH, Farrer JR Pneumorrhachis After Inadvertent Dural Puncture as a Cause of Severe Neck Pain Limiting Labor Participation and Necessitating Operative Vaginal Delivery: A Case Report. A A Pract, 2026.PMID 42257607
- [4]Jain D, Gandhi K, Gupta M, et al. A survey on labor epidural test dose practices in India. J Anaesthesiol Clin Pharmacol, 2025.PMID 40026751
- [5]Cook TM, Counsell D, Wildsmith JA, et al. Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. Br J Anaesth, 2009.PMID 19139027