Electrical Stimulation Test for Epidural Catheter Placement After Receiving Intrathecal Local Anesthetic During a Combined Spinal-epidural Technique for Cesarean Delivery: Confirmation of the Spinal Nerve Root as Epidural Site of Action

Abstract

(Can J Anesth/J Can Anesth. 2020;67:498–499) For the prediction of adequate epidural analgesia following abdominal surgery, the epidural stimulation test (EST) has been shown to have a higher sensitivity than the local anesthetic test dose. This test could confirm proper epidural catheter placement for combined spinal epidurals (CSEs) in either laboring women or women having a cesarean delivery. As epidural failure is a known complication of the CSE procedure, confirmation of the epidural catheter placement is a crucial step following a full spinal dose CSE for cesarean delivery. This case describes using EST to confirm CSE placement in a woman having cesarean delivery.