Abstract

CALVO, M. et al. Observational study of epidural analgesia used in labour: Complications of this technique in 5,895 pregnant women. Rev. Soc. Esp. Dolor [online]. 2005, vol.12, n.3, pp.158-168. ISSN 1134-8046.

Objectives: a) To determine the incidence of complications related to regional analgesia technique during the procedure, during dilatation and after delivery; and b) to ascertain whether post-delivery complications related to the analgesic technique are more frequent when the combined epidural-subarachnoid (CES) technique is used, compared to epidural analgesia. Material and method: We conducted a descriptive and analytical observational study. The study population included all women that demanded regional analgesia at the Epidural Analgesia Unit of our Hospital (5,895 pregnant women) and fulfilled all the inclusion criteria, from January 1, 2002 to January 1, 2003. Techniques used for the management of labour pain were epidural analgesia and combined epidural-subarachnoid technique. Results: The most frequent complication associated to the technique was paresthesia (43.5%) followed by hematic puncture (5.9%). Unintentional dura mater puncture occurred in 0.6%. The most frequent complications during the dilatation period were itching (11.4%) and lateralized analgesia (9%). The most frequent complications during the post-delivery period were back pain (9.8%) and headache (2%). Complications were, in general, more frequent among pregnant women undergoing the CES technique compared to the standard epidural analgesia. Conclusions: Complications that can appear due to this type of analgesia range from rare but potentially dangerous complications if they go unnoticed (such as intravascular injection of local anesthetics or total spine blockade) to more common complications such as paresthesia with still unknown long-term effects. Other complications, such as back pain or urinary retention, require controlled and randomized prospective studies on a high number of patients in order to clarify their potential association with epidural analgesia. Post-dural puncture headache appears in half the cases of unnoticed dural puncture, this usually occurring in 1.5% of pregnant women undergoing epidural analgesia technique. In our study, however, it occurred with a less-than-expected frequency, despite being a teaching hospital in Anesthesiology. Further extensive studies are also required in order to determine the actual incidence of complications, such as epidural hematoma or epidural abscess.

Keywords : Analgesia; Epidural; Complications; Obstetrics; Labour.

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