Continuous epidural anesthesia for elective cesarean hysterectomy

Continuous lumbar epidural anesthesia was the primary anesthetic technique used for 25 patients having elective cesarean hysterectomy at Duke University Medical Center during a 12 1/2-year interval. Seven patients (28%) with initially satisfactory epidural anesthesia required intraoperative induction of general orotracheal anesthesia because of patient discomfort and resultant suboptimal operating conditions. Careful patient selection and preparation, expertise in administering continuous epidural anesthesia, and understanding of the demands of the operative procedure are essential when planning epidural anesthesia for cesarean hysterectomy.