Epidural analgesia for elective Caesarean section. Technique and its assessment

A technique is described of epidural anaesthesia for electric Caesarean section which has a 98% success rate, and an acceptably low incidence of intra-operative pain. The essentials of the technique are to produce and maintain complete sensory block from S5 to T6, employing a two-stage injection of bupivacaine 0.5% (mean dose 23 ml) and the use of gravity to ensure sacral block. Despite the use of preoperative fluid loading and avoidance of caval occlusion, transitory hypotension occurred in 16% of patients. Vomiting, which occurred in 18% of patients, is a minor but distressing complication.