Spinal anesthetic dose following removal of an indwelling labor epidural catheter for patients who underwent unscheduled intrapartum cesarean delivery stratified by height and weight: a single-center retrospective study.

OBJECTIVE

The primary aim of our study was to report the dose of spinal hyperbaric bupivacaine 0.75% used for patients who had removal of an indwelling labor epidural catheter followed by a single injection spinal (SIS) or combined spinal-epidural (CSE) anesthetic technique for cesarean delivery anesthesia.

METHODS

Patients who had removal of an indwelling labor epidural catheter and performance of SIS or CSE anesthesia from January 1, 2020, through December 31, 2022, with complete data on height, weight, and spinal anesthetic dose were included in our study.

RESULTS

There were 56 and 212 patients who had SIS and CSE anesthesia, respectively, following removal of an indwelling labor epidural catheter. Patients received a median spinal dose of 9.8 and 10.5 mg for CSE and SIS anesthesia, respectively (P = 0.004). The spinal bupivacaine dose generally increased with increasing height and decreased with increasing weight. The observed incidence of high spinal block was 1:134 (95% confidence interval 1:37 to 488).

CONCLUSION

Height and weight can be utilized to determine dosing of spinal bupivacaine following removal of an indwelling labor epidural catheter.