Anaesthesia
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A number of obstetric fatalities related to epidural anaesthesia have been reported recently. In each case catheter or needle misplacement had resulted in a lethal intrathecal or intravascular injection. In this review these cases and a number of other similar but nonfatal reports are examined. ⋯ A detailed test dose protocol is recommended, which will safely warn of epidural catheter and needle misplacement in the most effective manner possible. If the protocol is used, accidental subarachnoid and intravascular injections can be reduced to a minimum, but they will still occur. It is emphasised that these complications should not cause fatalities if trained personnel and adequate resuscitation facilities are available.