Analgesia for External Cephalic Version

Obstetricians have shown renewed interest in external cephalic version (ECV) in an attempt to decrease the cesarean section rate because of breech presentation. Recent published studies have demonstrated increased success rates for ECV, versus matched historic controls, when epidural or CSE analgesia is provided. ^{[285] [286]} Indeed, anesthesia to facilitate ECV is not a new concept. In the 1960s, both Neely and Bonnar and colleagues described the use of anesthesia to assist ECV.^{[287] [288]} Provision of maternal analgesia with CSE creates a suitable environment for ECV; unlike older regional anesthesia techniques, it limits the use of excessive force by the obstetrician. If a serious complication occurs during ECV, the epidural catheter may be used to provide anesthesia for emergency cesarean section and avoid the complications of general anesthesia.