The Limitations of a Second Niraxial Technique for Labor Epidural Analgesia

There is a non-zero incidence of an inability to get a second niraxial. So I don't always do this technique but I have a preference to do it when I have time and the patients are minimal to it. When you do a spinal injection after the epidural space has been pressurized with labor epidural analgesia, there is a possibility that you could get a high level that necessitates intubation. And so in conclusion, I think that you get superior analgesia each and every time with a secondniraxial technique following removal of the labor epidural catheter.