Neurologic Complications of Pregnancy and Neuraxial Anesthesia

Reynolds, F.

doi:10.1016/b978-0-323-05541-3.00032-6

Cited by 7 publications

(15 citation statements)

References 186 publications

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“…We were uncertain of any further compression effect of an epidural or a spinal injection of local anesthetic in the volume needed to provide anesthesia for operative vaginal or abdominal delivery. 15 Admittedly conservative in our decision, we eschewed the use of neuraxial anesthesia. We counseled the patient and informed the obstetricians that we would not perform neuraxial analgesia/anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Anesthetic Implications of an Obstetric Patient with Blue Rubber Bleb Nevus Syndrome

Galey

Bharadwaj²,

Crimmins³

et al. 2016

A & A Case Reports

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Section: Discussionmentioning

confidence: 99%

“…[15][16][17] The neurosurgeon could not predict what the effects of (even pain free) labor would be on the incidence of rupture of an epidural venous malformation seen in BRBNS. The obstetricians elected a primary abdominal delivery for maternal indications.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Implications of an Obstetric Patient with Blue Rubber Bleb Nevus Syndrome

Galey

Bharadwaj²,

Crimmins³

et al. 2016

A & A Case Reports

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“…Epidural hematomas are rare occurrences at 1 in 500,000 to 700,000 obstetric epidural procedures. 71 A retrospective study conducted in Sweden from 1990 to 1999 found that the only two incidences of epidural hematoma occurred in patients with HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. 72 Risk factors include traumatic needle or catheter placement, coagulopathy or therapeutic anticoagulation, and spinal deformity (i.e., spinal tumor.)…”

Section: Epidural Hematomamentioning

confidence: 99%

“…This may be attributed to the physiologic hypercoagulable state of pregnancy. 71 Spontaneous epidural hema- toma is uncommon, but has been reported in parturients with no risk factors for coagulopathy, 75 as well as those with risk factors, such as patients with severe preeclampsia, 76 and those treated with low-molecular-weight heparin. 77,78 Peripheral Neuropathy Neurologic injury intrinsic to the childbirth process accounts for the vast majority of the neurologic injuries after childbirth.…”

Section: Epidural Hematomamentioning

confidence: 99%

Neurologic Issues and Obstetric Anesthesia

2011

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The rising popularity of regional anesthesia in the last several decades has greatly changed the experience of labor. Although the use of regional anesthesia has aided in decreasing maternal morbidity and mortality, a new dimension of neurologic issues, particularly headache and peripheral neuropathy, is apparent. Obstetric anesthesiologists frequently encounter patients with preexisting neurologic disease. Although very few of these disorders contraindicate the use of neuraxial technique, there are limited published data on specific neurologic and neuromuscular disorders in pregnancy. Neurologists are often consulted by anesthesiologists and obstetricians to evaluate pregnant patients for the feasibility of labor analgesia and when postpartum neurologic complications arise. Early consultation with an obstetric anesthesiologist, discussion with a neurologist, and communication with the obstetrician allows for the education and discussion of the risks and benefits of both the mode of delivery and anesthetic options. This multidisciplinary approach is crucial in forming reasonable expectations for the patient. The aim of this discussion is to provide an obstetric anesthesiologist's perspective on regional anesthesia and its implications in obstetrics, and to enhance communication between our specialties.

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“…Epidural catheters may injure nerve roots either because they are inappropriately rigid or because they are threaded too deeply and may compress a root, 34 although a flexible catheter is unlikely to do lasting damage to a nerve root in the epidural space.…”

Section: Side Effects and Complicationsmentioning

confidence: 99%

Epidural analgesia for labor: Current techniques

Silva¹,

Halpern²

2010

LRA

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Epidural analgesia is an extremely effective and popular treatment for labor pain. In this review, we trace the history of the use of epidural analgesia and its refinements. We then outline the goals of treatment and methods used to attain those goals. The use of low concentrations of local anesthetics, combined with lipid-soluble opioids, does not impede the progress of labor or depress the newborn. The incidence of side effects is low. Maintenance of analgesia that allows patient control enhances patient satisfaction.

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Neurologic Complications of Pregnancy and Neuraxial Anesthesia

Cited by 7 publications

References 186 publications

Anesthetic Implications of an Obstetric Patient with Blue Rubber Bleb Nevus Syndrome

Anesthetic Implications of an Obstetric Patient with Blue Rubber Bleb Nevus Syndrome

Neurologic Issues and Obstetric Anesthesia

Epidural analgesia for labor: Current techniques

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