The effect of intrathecal analgesia on the success of external cephalic version

External cephalic version (ECV), the procedure whereby a fetus in the breec h position is converted to vertex, is often performed to avoid an operative delivery. Potential benefits of epidural and spinal anesthesia for this pr ocedure are controversial. Several previous studies have evaluated the use of epidural anesthesia with varying results. We sought to determine whether analgesia produced by subarachnoid sufentanil would safely improve the suc cess of ECV. Patients who received subarachnoid analgesia (n = 20) were com pared with those who did not (n = 15) in regard to success of ECV, level of pain during ECV, and satisfaction. ECV was successful in 21 patients (60%) , with more frequent success in women who received spinal analgesia as comp ared with those who did not (80% vs 33%, respectively; P = 0.005). Patients who received spinals also reported smaller pain scores and were more satis fied with ECV. None of the women who received spinal analgesia developed a postdural puncture headache, and the only case of fetal bradycardia occurre d in a patient who did not receive spinal analgesia. More profound patient comfort after spinal analgesia may have permitted greater manipulation of t he abdomen during ECV, thus improving success rates of ECV without increasi ng risk.