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January 24, 1948

NEWBORN MORTALITY AND MORBIDITY WITH CONTINUOUS CAUDAL ANALGESIA: An Analysis of Cases in New York, Philadelphia and Memphis, with Controls

Author Affiliations

Memphis; New York; Philadelphia; Memphis

From the Departments of Obstetrics of the U. S. Marine Hospital, Staten Island, N. Y., the Philadelphia Lying-In Hospital and the John Gaston Hospital, Memphis. Surgeons, United States Public Health Service (Drs. Hingson and Edwards) and Senior Assistant Surgeon, United States Public Health Service (Dr. Franklin).

JAMA. 1948;136(4):221-229. doi:10.1001/jama.1948.02890210005002

Recognizing that the principles of prolonged narcosis in labor and general anesthesia for delivery are fundamentally dangerous for the baby, obstetricians in great numbers are filling the literature with reports of greater salvage of infants through management of labor and delivery with nerve conduction anesthesia through technics of local, pudendal and presacral block, spinal and continuous spinal, and saddleblock spinal anesthesia and caudal and continuous caudal analgesia.

Since 1942 there have been published two hundred and sixty-four papers in the medical literature recording results in more than 600,000 cases with continuous caudal analgesia used for the management of labor and delivery. Most of these reports have emphasized the well-being of the newborn infant who, with this technic, has escaped the penalty of transplacental narcosis from sedative drugs and general anesthetics.

In this report we have analyzed results in a significant number of deliveries from the U. S. Marine Hospital in