[Risk management in epidural anesthesia]

Masui. 2011 Nov;60(11):1259-66.
[Article in Japanese]

Abstract

Epidural anesthesia has many advantages, including block of surgical stress, postoperative pain management and prevention of postoperative complications. Therefore, we should use epidural anesthesia when indicated. However, patients with preexisting spinal stenosis or lumbar radiculopathy have higher incidence of neurologic complications after epidural anesthesia. Epidural abscesses caused by epidural anesthesia are rare. However, epidural abscesses are serious complications in patients. Knowing the risk factor of epidural abscesses is important to prevent epidural abscesses, and early diagnosis and early treatment are needed when suspected. It is important to have measures for safety in performing epidural anesthesia at every hospital. Recently, we have many anesthetic techniques, including epidural anesthesia, remifentanil infusion, ultrasound-guided peripheral nerve blocks and intravenous PCA. Therefore, we should choose an anesthesia method based on the careful evaluation of the benefit and risk balance for the patient's safety to reduce the incidence of complications.

Publication types

  • Review

MeSH terms

  • Anesthesia, Epidural* / adverse effects
  • Anesthesia, Epidural* / methods
  • Contraindications
  • Epidural Abscess / diagnosis
  • Epidural Abscess / etiology*
  • Epidural Abscess / prevention & control*
  • Epidural Abscess / therapy
  • Female
  • Humans
  • Male
  • Nervous System Diseases / etiology
  • Nervous System Diseases / prevention & control
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control*
  • Postoperative Complications / therapy
  • Risk Assessment
  • Risk Factors
  • Risk Management*
  • Spinal Cord Diseases
  • Spinal Dysraphism
  • Stress, Physiological / physiology
  • Surgical Procedures, Operative