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Complications Associated with Neuraxial Blockade

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Practical Trends in Anesthesia and Intensive Care 2018

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Abstract

The benefits of regional anaesthesia (RA), compared to general anaesthesia, are reduced morbidity and mortality, better postoperative analgesia and reduced cost.

However, regional anaesthesia is not completely free of risks. For central blocks, the appearance of adverse events has been sporadically reported.

Anaesthetic toxicity, transitory neurological symptoms, epidural haematoma and abscesses and nerve injury are the rare occurrences, which would require an extremely large number of patients to define the true incidence. The rate of neurological complications after central nerve blocks, which could be underestimated due to methodological aspects of the literature, can be estimated to be <4:10,000 (<0.04%), and the permanent neurological damage after RA is extremely rare in the current anaesthetic practice.

We present a review of the literature on the incidence of complications following RA and their principal clinical pictures.

Spinal haematoma being one of the most feared complications, a deep discussion is devoted to the patients under antithrombotic drugs, including the new oral anticoagulants.

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  1. Unit of Obstetric and Gynecological Anaesthesia – AOU Federico II, University of Napoli Federico II, Naples, Italy

    Edoardo De Robertis

  2. Department of Anaesthesiology and Intensive Care, Local Healthcare Unit “Naples 1”, S. Paolo Hospital, Naples, Italy

    Gennaro Scibelli & Lucia Maio

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  1. Edoardo De Robertis
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  2. Gennaro Scibelli
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  3. Lucia Maio
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Correspondence to Edoardo De Robertis .

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  1. Intensive Therapy, University of Milan, San Paolo Hospital, Milan, Italy

    Davide Chiumello

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De Robertis, E., Scibelli, G., Maio, L. (2019). Complications Associated with Neuraxial Blockade. In: Chiumello, D. (eds) Practical Trends in Anesthesia and Intensive Care 2018. Springer, Cham. https://doi.org/10.1007/978-3-319-94189-9_2

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  • DOI: https://doi.org/10.1007/978-3-319-94189-9_2

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