[Epidural abscess and regional anesthesia].
An epidural abscess is a rare lesion whose consequences can cause high morbi-mortality, particularly in obstetrics, where it occurs in young, healthy patients. With increased use of regional anesthesia, the incidence of epidural abscess will increase. We therefore review the risk factors, most common etiology and clinical signs, which may be non-specific but are nevertheless suggestive. We also review available diagnostic methods. It may be difficult to distinguish epidural abscess from other causes of medullar compression, but prompt diagnosis is essential so that emergency surgical repair can proceed and neurological recovery will be as early and complete as possible. Appropriate antibiotic therapy should be aggressive. Basic aseptic measures are critical for preventing infection through epidural needles, as the presence of infection at the moment of puncture facilitates greater susceptibility to epidural abscess.
Guasch Arévalo
E
E
Servicio de Anestesiología y Reanimación, Hospital Maternal La Paz, Madrid.
Suárez Cobián
A
A
D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001207:Asepsis; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D020802:Epidural Abscess / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D015994:Incidence; D007796:Laminectomy; D007958:Leukocyte Count; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D011247:Pregnancy; D011379:Prognosis; D011677:Punctures / Q000009:adverse effects*; D012307:Risk Factors; D020069:Shoulder Pain; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology
D000900:Anti-Bacterial Agents