The epidural test dose in obstetric anesthesia: It is not obsolete

Robert R. Gaiser

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Many anesthesiologists have called for the abandonment of the epidural test dose in the obstetric patient, citing its lack of sensitivity and specificity. A test dose of lidocaine 1.5% with epinephrine 1:200,000, in combination with aspiration, is highly effective in detecting incorrect placement of an epidural catheter. If the catheter is intrathecal, it requires approximately 2 minutes to obtain a sensory level. For the detection of an intravascular catheter, a positive test dose would result in a sudden increase in the maternal heart rate of 10 beats per minute within 1 minute after injection. It should not be administered during uterine contraction, as labor pain may trigger a tachycardic response. This test dose has been extensively studied and is safe both for both mother and fetus.

Original languageEnglish
Pages (from-to)474-477
Number of pages4
JournalJournal of Clinical Anesthesia
Issue number6
StatePublished - Sep 2003


  • Analgesia
  • Anesthesia
  • Catheterization
  • Epidural
  • Epidural test dose
  • Labor
  • Obstetrical
  • Obstetrics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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