PREVIOUS WET TAP DOES NOT REDUCE SUCCESS RATE OF LABOR EPIDURAL ANALGESIA

Whether unintentional dural puncture (wet tap) during a previous labor epidural increases the failure rate of epidural analgesia for later d eliveries is controversial. In this study, charts of 47 women with a p revious wet tap who received epidural analgesia for labor were compare d to those of 500 consecutive women receiving epidural analgesia in 19 91 and, separately, to 44 women matched for month of delivery, previou s epidural without a wet tap, and the same anesthesiologist. In compar ison to the 500 consecutive control patients, women with a previous we t tap had a lower incidence of epidural catheter manipulation for inad equate block (9% vs 20%), but a similar incidence of catheter removal for failed block (4% vs 6.7%). In comparison to matched control patien ts, women with a previous wet tap had a similar incidence of epidural catheter manipulation and removal for inadequate or failed blocks. Epi dural analgesia was considered successful in 93% of cases and 89% of m atched control subjects by chart review Two women (4%) with previous w et tap experienced a second wet tap during attempted epidural catheter ization, compared to 0% in 500 consecutive patients (P < 0.001). These data suggest that there is no decrease in the success rate of epidura l analgesia in women with a previous wet tap, although the chance for a repeated wet tap may be increased.