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Neurological complications of neuraxial blockade 

Neurological complications of neuraxial blockade
Neurological complications of neuraxial blockade

Vibeke Moen

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date: 28 November 2020

Neuraxial techniques for obstetric analgesia and anaesthesia are widespread, and serious complications are extremely rare. The most common of all complications following neuraxial blockade is postdural puncture headache, but headache may also be present in pathological conditions such as pre-eclampsia and sinus vein thrombosis. Headache may also be a symptom of cranial subdural haematoma, meningitis, and epidural abscess, all rare complications of central blockade, thus introducing a potential confounder in the newly delivered woman complaining of headache. Vertebral spinal haematomas are extremely rare in the healthy obstetric patient, but haemostatic disorders might develop following placement of an epidural catheter, thus increasing the possibility of spinal haematomas. Anaesthetists must be familiar with these rare complications, and perform neuraxial blockade avoiding traumatic damage, and using aseptic techniques. The anaesthetist will be involved in diagnosing a woman with neurological symptoms after labour and delivery, and must be familiar with common intrinsic obstetric neuropathies and clinical diagnostic procedures. This chapter describes complications following neuraxial blockade, as well as preventive and diagnostic procedures.

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