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Complications of Epidural Blockade

  • Ciaran Twomey
  • Ban C. H. Tsui

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.

Keywords

Epidural Analgesia Epidural Anesthesia Epidural Catheter Epidural Space Spinal Cord Stimulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Ciaran Twomey
    • 1
  • Ban C. H. Tsui
    • 1
    • 2
  1. 1.Department of Anesthesiology and Pain MedicineUniversity of Alberta, University of Alberta HospitalEdmontonCanada
  2. 2.University of Alberta Hospital and Stollery Children’s HospitalEdmontonCanada

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