Nerve injuries after neuraxial anaesthesia and their medicolegal implications.
Serious and permanent neurologic complications in the obstetric population are rare. Most neurologic complications following childbirth are intrinsic obstetric palsies. The most common intrinsic obstetric palsy is lateral femoral neuropathy. Palsies of the femoral, obturator, sciatic, common peroneal nerves and lumbosacral plexus have also been reported. Meticulous technique during neuraxial anaesthesia will decrease the risk of injury secondary to neuraxial procedures. Direct trauma to the spinal cord and spinal nerves may occur during neuraxial anaesthesia. Sterile technique should be employed during neuraxial procedures and precautions should be taken to ensure that the proper drug/concentration is being injected. Postpartum complaints should be addressed promptly. For infection and space-occupying lesions of the neuraxial canal, prompt diagnosis and treatment are essential to prevent permanent injury or death. Survey studies have demonstrated that women want to be told of the risks of neuraxial procedures, even when the incidence is rare.
Wong
Cynthia A
CA
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. c-wong2@northwestern.edu <c-wong2@northwestern.edu>
D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology* / Q000517:prevention & control; D010243:Paralysis / Q000209:etiology; D011247:Pregnancy; D012308:Risk Management; D013119:Spinal Cord Injuries / Q000209:etiology; D013127:Spinal Nerves / Q000293:injuries