Complications of epidural infusions for analgesia in postoperative and trauma patients

Am Surg. 1997 Jun;63(6):543-6.

Abstract

Few studies compare complications of continuous and bolus epidural analgesia. Ninety-eight postoperative and trauma patients receiving epidural infusions over 15 months were retrospectively studied. Continuous epidural analgesia was used for pain management in 60 patients (61%). Bolus epidural analgesia was administered to 38 patients (39%). Sixty patients reported 98 complications. Sixty-eight per cent of complications occurred in patients receiving continuous infusions. For the continuous infusions, motor blockade (18%), nausea/vomiting, (18%), and catheter leaks (12%) were the most common complications. For bolus infusions, nausea/vomiting (25%), mental status changes (21%), and erythema at placement site (13%) were encountered. Continuous infusions were associated with an increased incidence of complications compared with bolus infusions (P < 0.05). Patients undergoing abdominal surgery had an increased incidence of complications compared with other patients (P < 0.05). Epidural catheters are safe and effective for pain management, but they are not without risk. Hemodynamic stability and pulmonary status should be considered when evaluating patients.

MeSH terms

  • Analgesia, Epidural / adverse effects*
  • Analgesia, Epidural / methods
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Pain, Postoperative / therapy*
  • Postoperative Period
  • Retrospective Studies
  • Wounds and Injuries / surgery