title: Complications of epidural infusions for analgesia in postoperative and trauma patients.
abstract: Few studies compare complications of continuous and bolus epidural analgesia. Ninety-eight postoperative and trauma patients receiving epidural infusions over 15 months were retrospectively studied. Continuous epidural analgesia was used for pain management in 60 patients (61%). Bolus epidural analgesia was administered to 38 patients (39%). Sixty patients reported 98 complications. Sixty-eight per cent of complications occurred in patients receiving continuous infusions. For the continuous infusions, motor blockade (18%), nausea/vomiting, (18%), and catheter leaks (12%) were the most common complications. For bolus infusions, nausea/vomiting (25%), mental status changes (21%), and erythema at placement site (13%) were encountered. Continuous infusions were associated with an increased incidence of complications compared with bolus infusions (P < 0.05). Patients undergoing abdominal surgery had an increased incidence of complications compared with other patients (P < 0.05). Epidural catheters are safe and effective for pain management, but they are not without risk. Hemodynamic stability and pulmonary status should be considered when evaluating patients.
authors.affiliation: Department of Surgery, Conemaugh's Memorial Medical Center, Johnstown, Pennsylvania 15905, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kurek
authors.forename: J
authors.initials: J
authors.lastname: Lagares-Garcia
authors.forename: R
authors.initials: R
authors.lastname: Casella
authors.forename: D
authors.initials: D
authors.lastname: Meenan
authors.forename: K M
authors.initials: KM
authors.lastname: Hughes
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D011184:Postoperative Period; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000601:surgery