SERKAN DOĞRU, Ziya KAYA, HATİCE YILMAZ DOĞRU

Epidural anestezinin ciddi komplikasyonları

Epidural anestezi, anestezi uygulamalarında iyi tanınmış ve yer edinmiş bir rejyonel anestezi tekniğidir. İlk kez 1895’te Cathelin tarafından sakral bölgede uygulanmış ve günümüzde temel bölgesel anestezi yöntemi haline gelmiştir. Uygulamadaki artış, beraberinde bradikardi, kardiyak arrest, nörolojik ve enfektif komplikasyonlar gibi epidural anestezinin ciddi komplikasyonlarında da artış meydana getirmiş, ancak günümüzde uygulamada ve teknik konusundaki yenilikler neticesinde anestezistler tarafından sıklıkla başvurulan bir yöntem haline gelmiştir. Bu derlemede, güncel literatürler eşliğinde epidural anestezinin ciddi komplikasyonlarını incelemeyi amaçladık.

Serious complications of epidural anesthesia

Epidural anesthesia is a well-recognized and identified regional anaesthesia technique in anesthesia practice. First applied at sacral region in 1895 by Cathelin and today it has become a basic regional anaesthesia technique. Frequent application of epidural anesthesia has caused an increase at serious complications like bradycardia, cardiac arrest, neurologic and infective complications. But now, it has become a frequent practice for anesthesiologists under developments in practices and techniques. We aim to review serious complications of epidural anesthesia within current literatures.

PDF

___

1. Fisher B. Techniques of epidural block. Anaesth Intensive Care 2009;10(11):552-6.
2. Morgan P. The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia. Can J Anaesth 1994;41(5):404-13.
3. Andres J, Reina MA, Prats A. Epidural space and regional anesthesia. Eur J Pain 2009;3(2):55-63.
4. Dale MC, Checketts MR. Complications of regional anaesthesia. Anaesth Intensive Care 2010;11(3):85-8.
5. Horlocker TT. Complications of regional anaesthesia. Eur J Pain 2010;4(S4):227-34.
6. Sawardekar A, Suresh S. Neuroaxial blockade in children. Anaesth Intensive Care Med 2010;11(6):229-31.
7. Mathur V, Bravos D, Vallera C, Wu CL. Regional anesthesia and patient outcomes: evidence-based medicine. Tech Reg Anesth Pain Manag 2008;12(4):163-70.
8. Beaussier M, Atchabahian A, Dufeu N. Regional anesthesia and the perioperative period: basis and principles. Tech Reg Anesth Pain Manag 2008;12(4):171-7.
9. Irita K, Kawashima Y, Morita K, et al. Critical incidents during regional anesthesia in Japanese Society of Anesthesiologists- Certified Training Hospitals: an analysis of responses to the annual survey conducted between 1999 and 2002 by the Japanese Society of Anesthesiologists. Masui 2005;54(4):440-9.
10. Pollard JB. Common mechanisms and Strategies for Prevention and Treatment of Cardiac Arrest During Epidural Anesthesia. J Clin Anesth 2002;14(1):52-6.
11. Horlocker TT. Complications of Regional Anesthesia and Acute Pain Management. Anesthesiol Clin 2011;29(2):257-78.
12. Kinsella SM, Tuckey JP. Perioperative bradycardia and asystole: relationship to vasovagal syncope and the Bezold-Jarish reflex. Br J Anaesth 2001;86(6):859-68.
13. Liguori GA, Sharrock NE. Asystole and severe bradycardia during epidural anesthesia in orthopedic patients. Anaesthesiology 1997;86(1):250-7.
14. Souza RL, Andrate LOF, Silva JB, Silva LAC. Neuraxial hematoma after epidural anesthesia. Is it possible to prevent or detect it? Report of two cases. Rev Bras Anesthesiol 2011;61(2):218- 24.
15. Sertöz N, Demir F, Ayanoğlu HÖ. Epidural kateter çekilmesi sonrasi spinal hematom. Türk Anest Rean Der Dergisi 2010;38(2):142-6.
16. Stoll A, Sanchez M. Epidural hematoma after epidural block: implications for its use in pain management. Surg Neurol 2002;57(4):235-40.
17. Neal JM, Bernards CM, Hadzic A, et al. ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine. Reg Anesth Pain Med 2008;33(5):404-15.
18. Pollock JE. Neurotoxicity of intrathecal local anaesthetics and transient neurological symptoms. Best Pract Res Clin Anaesthesiol 2003;17(3):471-84.
19. Russell R, Soltanifar S. Neurological complications in obstetric regional anesthesia. Anaesth Intensive Care Med 2010;11(8):316-8.
20. Rigg JRA, Jamrozik K, Myles PS, et al. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet 2002;359(9314):1276-82.
21. Wu KC, Chiang YY, Lin BC, et al. Epidural cyst with cauda equina syndrome after epidural anesthesia. Acta Anaesthesiol Taiwan 2010;48(3):148-51.
22. Drasner K. Local anesthetic neurotoxicity: Cauda equina syndrome. In: Burkey D. Regional Anesthesia and Pain Management Handbook, 1st edn. Philadelphia: Saunders Elsevier 2009:227-9.
23. Auroy Y, Benhamou D, Bargues L, et al. Major complications of regional anesthesia in France. Anesthesiology 2002;97(5):1274-80.
24. Horlocker TT, Wedel DJ. Infectious complications of regional anesthesia. Best Pract Res Clin Anaesthesiol 2008;22(4):451- 75.
25. Ready LB, Helfer D. Bacterial Menengitis in parturients after epidural anesthesia. Anesthesiology 1989;71(6):988-90.
26. Bandikatla VB, Rizwan B, Skalimis A, Patel H. Spinal epidural abscess and meningitis following an epidural catheterisation. Acute Pain 2007;9(1):35-8.
27. Hebl JR. The importance and implications of aseptic techniques during regional anesthesia. Reg Anesth Pain Med 2006;31(4):311-23.
28. Pinder A. Complications of obstetric anaesthesia. Curr Anaesth Crit Care 2006;17(3):151-62.
29. Paech MJ, Godkin R, Webster S. Complications of obstetric epidural analgesia and anaesthesia: a prospective analysis of 10 995 cases. Int J Obstet Anesth 1998;7(1):5-11.
30. Ruppen W, Derry S, McQuay H, Moore A. Incidence of epidural hematoma, infection and neurologic injury in obstetric patients with epidural analgesia/anesthesia. Anesthesiology 2006;105(2):394-9.
31. Eldor J. Local anaesthetic antibacterial activity. Anaesthesia 2003;58(9):926-8.
32. Wu CL. Regional anesthesia and anticoagulation. J Clin Anesth 2001;13(1):49-58.
33. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombotic therapy. Reg Anesth Pain Med 2010;35(1):64-101.