title: Neuroaxial blocks and tattoos: a dilemma?
abstract: OBJECTIVE
  Parturients with lumbar tattoos are often proposed to neuroaxial blocks (NB). There are no guidelines for this situation, and no reports of major complications derived from NB through tattoos. We conducted a survey of a sample of anaesthetists, to find out about their approach when facing NB on parturients with lumbar tattoos.
  
  
  METHODS
  We surveyed 537 anaesthetists through a multiple choice questionnaire. The obtained data were subjected to a descriptive analysis.
  
  
  RESULTS
  A total of 162 replies were received. Ninety-two anaesthetists had already been asked to carry out a NB through a tattoo. Fifty-five of them executed the NB on all occasions, always on pigment free skin, 6 always refused to do so, and 31 didn't always performed the NB. Most of these approaches were based on literature. This is according to the fact that literature is not unanimous, which explains opposite actions having similar backgrounds. Of the 70 anaesthetists never confronted with this situation, 74.3% would carry it out when faced with that situation, being that 67.2% would do it over an ink free area, while 7.1% would choose the pigmented one. Personal opinion is the major grounding for this group.
  
  
  CONCLUSIONS
  A tendency towards performing NB on pigment free skin, seems to exist. Literature has been the backup for anaesthetists confronted with the above scenario, while personal opinion seems to have been the basis for the remainders. The nonexistence of guidelines as well as the controversy regarding the risks involved in performing NB over tattoo, probably explain the diverse actions taken by the anaesthetists.
authors.affiliation: Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Rua das Adelas no.2, Lisbon, Portugal. gaspana@gmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: Gaspar
authors.forename: Nuno
authors.initials: N
authors.lastname: Serrano
mesh_terms: D016362:Analgesia, Obstetrical / Q000379:methods*; D003625:Data Collection; D005260:Female; D006801:Humans; D009407:Nerve Block; D011174:Portugal; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D013653:Tattooing / Q000009:adverse effects*