Small Risk of Serious Neurologic Complications Related to Lumbar Epidural Catheter Placement in Anesthetized Patients

Horlocker, Terese T.; Abel, Martin; Messick, Joseph M.; Schroeder, Darrell R.

doi:10.1213/01.ane.0000057600.31380.75

Cited by 114 publications

(69 citation statements)

References 17 publications

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“…Horlocker et al [22] reported that there was no direct neurologic complication in 4,298 thoracic surgery patients undergoing lumbar epidural catheter placement in anesthetized patients. Acute paraplegia after epidural anesthesia can result from spinal cord compression, spinal cord infarction and cord trauma.…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Paresthesia and Neurologic Complications after Lower Spinal Thoracic Puncture with Cut Needle Compared to Pencil Point Needle. Study in 300 Patients

Imbelloni¹,

Pitombo²,

Ganem³

2010

J Anesthe Clinic Res

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Section: Discussionmentioning

confidence: 99%

The Incidence of Paresthesia and Neurologic Complications after Lower Spinal Thoracic Puncture with Cut Needle Compared to Pencil Point Needle. Study in 300 Patients

Imbelloni¹,

Pitombo²,

Ganem³

2010

J Anesthe Clinic Res

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“…5 Large-scale studies conducted in adults have reported an incidence of transient or permanent neurological injury of 1-8 in 10,000 epidurals. [6][7][8][9][10][11][12][13] There is a paucity of studies examining major complications related to epidural analgesia in children. Many pediatric studies contain patient numbers of 200 or less.…”

Section: Résumémentioning

confidence: 99%

Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals

Wong

Arab

Chew

et al. 2013

Can J Anesth/J Can Anesth

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Background Complications associated with epidural analgesia in children have a reported incidence of 40-90 in 10,000 epidurals. We sought to determine the incidence of major complications with the use of continuous epidural analgesia that occurred in our centre over the past 15 years and to describe the nature of these complications. Methods The Acute Pain Service database at a tertiary care academic pediatric hospital was reviewed retrospectively over a 15-year period. Data were categorized according to patient age (neonate, infant, child one through eight years, and child [ eight years), mode of insertion of the epidural (caudal, transsacral, lumbar, thoracic), complication type, and complication severity. Results Over the 15-year period, 3,152 epidurals were performed. The use of caudal-thoracic epidurals in neonates and infants has increased since 2007. Twenty-four major complications were identified (incidence, 7.6 in 1,000 epidurals). The rate of complications in neonates

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“…O paciente evoluiu com siringomielia de T 5 a T 10 , disestesia de T 6 a T 10 , diminuição da força no membro inferior esquerdo e disfunções vesical e intestinal. Não há estudos prospectivos, comparativos com distribuição aleatória dos pacientes que comparem os riscos relativos da anestesia regional realizada em pacientes conscientes e anestesiados 16 . Tsui e col. 17 relataram um caso de lesão medular após anestesia peridural torácica realizada no paciente adulto acordado.…”

Section: Discussionunclassified

“…The patient developed syringomyelia from T 5 to T 10 , dysesthesia from T 6 to T 10 , decreased strength in the left lower limb, and bladder and intestinal dysfunction. There are no prospective, randomized studies comparing the relative risks of regional block in conscious and anesthetized patients 16 . Tsui et al 17 reported one case of spinal cord injury after thoracic epidural block in a conscious, adult patient.…”

Section: Neurological Complications and Damage Of Regional Block In Cmentioning

confidence: 99%

Complicações e seqüelas neurológicas da anestesia regional realizada em crianças sob anestesia geral: um problema real ou casos esporádicos?

Costa¹,

Rodrigues²,

Fernandes³

et al. 2006

Rev. Bras. Anestesiol.

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Rev Bras AnestesiolARTIGO CIENTÍFICO 2006; 56: 6: 583-590 SCIENTIFIC ARTICLE RESUMO Costa VV, Rodrigues MR, Fernandes MCBC, Saraiva RA -Complicações e Seqüelas Neurológicas da Anestesia Regional Realizada em Crianças sob Anestesia Geral. Um Problema Real ou Casos Esporádicos? JUSTIFICATIVA E OBJETIVOS:Tem sido discutido se a técnica de anestesia regional em crianças, que na maioria das vezes é realizada após a anestesia geral, é realmente segura. Há o risco potencial de uma lesão neurológica permanente ou temporária quando o paciente não pode informar eventual parestesia ou dor, durante a realização da anestesia regional, o que gera insegurança por parte dos anestesiologistas. O objetivo deste estudo foi avaliar a prevalência de complicações e seqüelas neurológicas da anestesia regional em crianças sob anestesia geral. MÉTODO:Numa análise prospectiva foram estudadas crianças submetidas a intervenções cirúrgicas ortopédica e plástica reparadora sob anestesia regional associada à anestesia geral. A indução e a manutenção da anestesia foram por vias venosa ou inalatória. Após anestesia geral era realizada anestesia regional e avaliada a existência de complicações imediatas, o número de punções realizadas, complicações de médio prazo e presença de seqüelas neurológicas.RESULTADOS: Num período de 13 meses foram estudadas 499 crianças de ambos os sexos, com idade média de 6,7 anos. A maioria dos pacientes foi submetida à anestesia geral associada à peridural lombar ou caudal. A prevalência de complicação imediata foi 3,6%, sendo a mais freqüente o sangramento no momento da punção. A prevalência de complicações em médio prazo foi 1,1%, sendo a mais freqüente a hipoestesia e não houve seqüela neurológica de longo prazo. CONCLUSÕES:Os resultados do presente estudo são concordantes com os de outros autores com relação à baixa prevalência de complicações da anestesia regional em crianças sob anestesia geral, sem deixar seqüelas neurológicas. Isso pode ser atribuído ao uso de material adequado e a experiência da equipe de anestesia.Unitermos: ANESTESIA, Pediátrica; COMPLICAÇÕES: Seqüela neurológica; TÉCNICAS ANESTÉSICAS, Regional: peridural, lombar, sacra. SUMMARY BACKGROUND AND METHODS:It has been questioned whether regional block in children, which most of the time is done under general anesthesia, is really safe. There is the potential risk of permanent or temporary neurological damage when the patient cannot complain of eventual paresthesia or pain while the block is being performed, making anesthesiologists very insecure. The aim of this study was to evaluate the prevalence of neurological complications and damage of regional block in children under general anesthesia. METHODS:A prospective analysis of children who underwent orthopedic and reconstructive plastic surgeries under regional block associated with general anesthesia was undertaken. Anesthesia was induced and maintained by the intravenous or inhalational route. Regional block was done after general anesthesia and immediate complications, number of punctur...

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Small Risk of Serious Neurologic Complications Related to Lumbar Epidural Catheter Placement in Anesthetized Patients

Cited by 114 publications

References 17 publications

The Incidence of Paresthesia and Neurologic Complications after Lower Spinal Thoracic Puncture with Cut Needle Compared to Pencil Point Needle. Study in 300 Patients

The Incidence of Paresthesia and Neurologic Complications after Lower Spinal Thoracic Puncture with Cut Needle Compared to Pencil Point Needle. Study in 300 Patients

Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals

Complicações e seqüelas neurológicas da anestesia regional realizada em crianças sob anestesia geral: um problema real ou casos esporádicos?

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