Failure of Neuraxial Anesthesia for Postpartum Tubal Ligation: A Single-center Retrospective Cohort Study

Can J Anesth/J Can Anesth . 2025;72:1379–1386. doi: 10.1007/s12630-025-03004-3 Postpartum tubal ligation (PPTL) is a commonly performed procedure intended to provide permanent contraception following vaginal delivery. Several anesthetic approaches may be used, including reactivation of an existing labor epidural, de novo single-injection spinal (SIS) anesthesia, combined spinal–epidural (CSE) anesthesia, or general anesthesia. Previous studies have reported variable failure rates for neuraxial anesthesia (NA) during PPTL, prompting further evaluation of factors associated with unsuccessful blocks. The present study sought to determine the rate of de novo NA failure for PPTL at a single academic medical center and to identify clinical variables associated with failure.