Abstract

Background: External cephalic versions (ECVs) are used to move a fetus from breech position into a vertex position to allow for safer vaginal delivery. Neuraxial anesthesia has been studied as a method of pain control and for its ability to increase ECV success rates with mixed results. The purpose of this integrative review is to examine the current evidence and provide guidance in neuraxial anesthetic care of patients undergoing external cephalic version.

Methods: A search of the electronic databases PubMed and Cochrane was performed. Twenty-one articles published from 1994 -2020 were analyzed using an evidence matrix. Twenty of those articles were used for this paper.

Results: Seven/eleven studies found neuraxial anesthesia to be superior to no analgesia/anesthetic intervention or IV analgesia. All the studies, except one, that showed neuraxial to improve ECV success rates used spinal 0.5% bupivacaine or 2% lidocaine for epidural to provide a dense block. One/eleven studies found an increase in emergent cesarean sections with neuraxial anesthesia. All five studies that documented pain scores found neuraxial to be superior.

Conclusions: Neuraxial anesthesia improves ECV success rates and reduces maternal pain scores when a denser block is provided without demonstrating an increased risk for emergent cesarean.

Jessica L. Kuhr

Author Details

Jessica L. Kuhr, DNAP, CRNA

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

External Cephalic Version, Anesthesia, Spinal Anesthesia, Epidural, Regional Anesthesia, Analgesia, Anesthetic Intervention

Advisor

Pecka, Shannon

Degree

Doctoral-Other

Degree Grantor

Bryan College of Health Sciences

Degree Year

2022

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Proxy-submission

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