Epidural Anesthesia in Toxemia of Pregnancy

To the Editor: In their review of hypertension in pregnancy (Sept. 12 issue),¹ Lindheimer and Katz state, “Epidural block should be avoided, since in preeclampsia it is associated with sudden and marked falls of blood pressure and on occasion with vascular collapse.” Obstetric anesthesiologists generally believe that epidural anesthesia is the analgesic method of choice for labor and delivery in patients with toxemia if plasma volume deficit has been corrected, coagulation is adequate, and blood pressure (diastolic pressure less than 110 torr) is controlled by other means.^{2 3 4} Regional anesthesia is the most effective and reliable method of providing adequate pain.