title: Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia.
abstract: The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery. Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter. The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.
authors.affiliation: Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Vaida
authors.affiliation: Preoperative clinic, Department of Anesthesiology, The University of Texas Medical School at Houston, Houston, Texas, 77030, USA.
authors.forename: Davide
authors.initials: D
authors.lastname: Cattano
authors.affiliation: Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Hurwitz
authors.affiliation: Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.
authors.forename: Berend
authors.initials: B
authors.lastname: Mets
keywords: Anesthesia for cesarean delivery; Epidural labor analgesia; Unsatisfactory labor epidural analgesia