Tuesday, 20 March 2007

Safety of Epidural Analgesia for Childbirth

This is from Anesthesiology in August 2006, but still important.
Ruppen et al. present a meta-analysis of well over one million parturients describing the incidence of serious neurologic injuries, including infection, after epidural analgesia and anesthesia. 1.37 million women are included in this risk analysis. This is the largest study to date on these complications. An associated editorial comments on the importance of risk factors, and standards of care including full sterile precautions and allowing adequate time for antiseptics to work (2 minutes is quoted)

The Key findings are

  • Epidural haematoma 1 in 168,000
  • Deep epidural infection, 1 in 145,000
  • Persistent neurologic injury, 1 in 240,000
  • Transient neurologic injury, 1 in 6,700

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