Serious non-fatal complications associated with extradural block in obstetric practice.
A retrospective study of serious non-fatal complications of extradural block in obstetric practice was carried out using a postal questionnaire. Two hundred and three obstetric units in the United Kingdom (responsible for 2,580,000 deliveries from 1982 to 1986 inclusive) responded. A total of 505,000 extradural blocks were performed, 84% for relief of pain in labour and 16% for Caesarean section. Of 108 events reported, five were associated with permanent disability. Neuropathy involving a single spinal nerve, acute toxicity from the local anaesthetic, and problems associated with accidental dural puncture were the commonest complications. This investigation indicates the need for a prospective study. Although rare, serious complications could be reduced further by meticulous technique, while early diagnosis and treatment of untoward events would reduce the incidence of permanent disability.
Scott
D B
DB
Department of Anaesthesia, Royal Infirmary, Edinburgh.
Hibbard
B M
BM
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D002585:Cesarean Section; D004388:Dura Mater / Q000293:injuries; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000209:etiology; D013127:Spinal Nerves / Q000293:injuries; D006113:United Kingdom