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July 3, 1943


Author Affiliations

Parsons, W. Va.

From the Tucker County Hospital.

JAMA. 1943;122(10):671-672. doi:10.1001/jama.1943.72840270004009b

Because of the widespread interest and enthusiasm now being shown in caudal anesthesia for obstetrics, this case is reported as a warning of its most serious complication, namely high spinal anesthesia, even though a technic was used which was designed expressly to avoid this complication.

A secundigravida aged 23, whose previous medical and obstetric history was noncontributory except for a syphilitic infection acquired five years previously but adequately treated and with negative serologic and spinal fluid findings at present, was admitted in active labor with the cervix three fingerbreadths dilated and the head in midpelvis, the presentation being left anterior oblique. The membranes were intact. Blood pressure was 120/80. The general medical examination revealed no abnormalities. Caudal anesthesia was begun immediately, the technic recommended by Hingson and Edwards1 being used with one modification designed to minimize the danger of depositing the metycaine solution in the subarachnoid space. This procedure