Epidural anesthesia for postpartum tubal ligation using epidural catheters placed during labor

To evaluate the success of epidural anesthesia for postpartum tubal ligation using epidural catheters placed during labor and to determine whether patient characteristics, timing of surgery, or technical factors (e.g., length of epidural catheter inserted into the epidural space) influenced the success of subsequent epidural anesthesia.

Retrospective study.

University hospital labor and delivery suite.

90 consecutive women scheduled for postpartum tubal ligation using epidural catheters placed during labor.

Epidural catheters were reinjected with 1.5% to 2% lidocaine with epinephrine 5 micrograms/ml or 2% to 3% 2-chloroprocaine immediately before surgery.

74% of the women received satisfactory intraoperative anesthesia using in situ epidural catheters. Reinjecting the catheter within 4 hours of delivery was associated with a greater frequency of successful epidural anesthesia for tubal ligation (95% vs. 67%; p = 0.029). There was no significant difference between the two groups in the length of catheter inserted into the epidural space.

Although other factors may influence the timing of postpartum tubal ligation after delivery, the success of epidural anesthesia for tubal ligation using in situ epidural catheters is greater if surgery is performed shortly after delivery.