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Neuraxial anesthesia for external cephalic versions: A review

Abstract

Anesthesia and analgesia in external cephalic versions (ECVs) may improve success rates without significant increases in adverse effects. In light of the potential to decrease cesarean sections using ECVs, there is significant initiative to increase success rates for ECVs. Prior studies have demonstrated that neuraxial blockade may improve success rates of ECVs, and that this may be dependent on anesthetic or analgesic drug choice and dosing. Neuraxial blockade has included epidural, spinal, and combined spinal epidural (CSE) methods. Thus, this review intends to determine if the use of neuraxial anesthesia improves ECV success outcomes and decreases cesarean deliveries. Methods: PubMed and Cochrane database searches were performed using search terms “external cephalic version,” “anesthesia,” and “analgesia.” Studies were screened based on title and abstract, and deemed eligible based on study design, English text availability, and published status. Of the 179 initially identified studies, 19 studies published between 1994-2016 were selected for examination. These studies consisted of 10 randomized controlled trials, 5 prospective and 3 retrospective studies, and 1 survey.

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