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Complications of Regional Anesthesia pp 167–192Cite as

Complications of Epidural Blockade

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Abstract

Epidural anesthesia was first reported by Sicard and Cathelin in France, in 1901.1 Whereas continuous techniques were pioneered by Hingson et al.2 and Tuohy,3 Dawkins4 and Bromage5 established lumbar epidural anesthesia as the gold standard for the management of labor pain. As these techniques evolved, undesirable effects became apparent; those that were repeatedly seen were judged to be side effects of the technique, and were accepted as an expected and predictable part of practice. Less common, more serious outcomes may be considered complications; these events may result in significant morbidity or mortality if left unchecked. Anesthesiologists should take great care to identify those patients at risk of developing serious complications, and must make risk-benefit evaluations in determining the suitability of a particular technique. In some cases in which the absolute risk may be difficult to quantify, and the outcome may be potentially catastrophic, the practitioner may exclude an entire subset of the patient population (e.g., the anticoagulated patient and the risk of epidural hematoma). There are a multitude of factors that can lead to adverse epidural usage outcomes. Safety in clinical practice is a complex system, which is beyond description within the confines of this paragraph. However, careful patient selection and adherence to established guidelines form the cornerstones of complication prevention.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Alberta, University of Alberta Hospital, Edmonton, Alberta, Canada

    Ciaran Twomey MB, BCh, BAO (UNI), FCARCSI (Clinical Fellow) & Ban C. H. Tsui M Sc, MD, FRCPC (Assistant Professor and Director of Clinical Research)

  2. University of Alberta Hospital and Stollery Children’s Hospital, Edmonton, Alberta, Canada

    Ban C. H. Tsui M Sc, MD, FRCPC (Assistant Professor and Director of Clinical Research)

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  1. Ciaran Twomey MB, BCh, BAO (UNI), FCARCSI
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  2. Ban C. H. Tsui M Sc, MD, FRCPC
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Editors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada

    Brendan T. Finucane MB, BCh, BAO, FRCA, FRCPC (Professor) (Professor)

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Twomey, C., Tsui, B.C.H. (2007). Complications of Epidural Blockade. In: Finucane, B.T. (eds) Complications of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68904-3_10

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