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To the Editor:—
Any advancement in the field of childbirth pain relief is highly welcomed and should receive prompt and due recognition. There are sufficient disadvantages and contraindications to the method, as indicated in the article of Gready and Hesseltine (The Journal, January 23). To those listed by them can be added the following, several of which have been observed in our clinic at Indiana University: It is exclusively a hospital procedure and therefore restricted to 60 per cent of laboring women. The necessity for a competent attendant further restricts the use of the method. The method is rather technical—at least the insertion of the caudal needle must be done by one specially trained—either the obstetrician or a resident. There is an undesirably high percentage of failures. Hingson and Edwards report 11 per cent, necessitating discontinuance of the method or supplementing other anesthesia. Such contraindications as hypotension, hypertension, placenta previa,
McCormick CO. CONTINUOUS CAUDAL ANALGESIA IN OBSTETRICS. JAMA. 1943;121(9):700. doi:10.1001/jama.1943.02840090070029