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Although the use of intrathecal catheters after inadvertent dural puncture in labour has increased in popularity over recent decades, robust evidence on best practice has been lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Obstetric Anaesthetists' Association set up an expert working party to review the literature. A modified Delphi approach was used to produce statements and recommendations on insertion and management of intrathecal catheters for labour and operative delivery following inadvertent dural puncture during attempted labour epidural insertion. Statements and recommendations were graded according to the US Preventive Services Task Force grading methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 296 articles were identified in the initial literature search. Further screening identified 111 full text papers of relevance. A structured narrative review was produced which covered insertion of an intrathecal catheter; initial dosing; maintenance of labour analgesia; topping\u2010up for operative delivery; safety features; complications; and recommended follow\u2010up. The working party agreed on 17 statements and 26 recommendations. These were generally assigned a low or moderate level of certainty. The safety of mother and baby were a key priority in producing these guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With careful management, intrathecal catheters can provide excellent labour analgesia and may also be topped\u2010up to provide anaesthesia for caesarean or operative vaginal delivery. The use of intrathecal catheters, however, also carries the risk of significant drug errors which may result in high\u2010 or total\u2010spinal anaesthesia, or even cardiorespiratory arrest. It is vital that all labour wards have clear guidelines on the use of these catheters, and that staff are educated as to their potential complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16434","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T03:56:45Z","timestamp":1727409405000},"page":"1348-1368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Intrathecal catheter placement after inadvertent dural puncture in the obstetric population: management for labour and operative delivery. Guidelines from the Obstetric Anaesthetists' Association"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5323-290X","authenticated-orcid":false,"given":"Sarah K.","family":"Griffiths","sequence":"first","affiliation":[{"name":"Department of Anaesthetics Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7294-6629","authenticated-orcid":false,"given":"Robin","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8648-7483","authenticated-orcid":false,"given":"Malcolm A.","family":"Broom","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Glasgow Royal Infirmary and Princess Royal Maternity Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0931-7891","authenticated-orcid":false,"given":"Sarah","family":"Devroe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences Catholic University Leuven  Leuven Belgium"},{"name":"Department of Anaesthesiology University Hospital Gasthuisberg  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8638-5287","authenticated-orcid":false,"given":"Marc","family":"Van de Velde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences Catholic University Leuven  Leuven Belgium"},{"name":"Department of Anaesthesiology University Hospital Gasthuisberg  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-2067","authenticated-orcid":false,"given":"D. 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