Complications Associated with Neuraxial Blockade

  • Edoardo De RobertisEmail author
  • Gennaro Scibelli
  • Lucia Maio


The benefits of regional anaesthesia (RA), compared to general anaesthesia, are reduced morbidity and mortality, better postoperative analgesia and reduced cost.

However, regional anaesthesia is not completely free of risks. For central blocks, the appearance of adverse events has been sporadically reported.

Anaesthetic toxicity, transitory neurological symptoms, epidural haematoma and abscesses and nerve injury are the rare occurrences, which would require an extremely large number of patients to define the true incidence. The rate of neurological complications after central nerve blocks, which could be underestimated due to methodological aspects of the literature, can be estimated to be <4:10,000 (<0.04%), and the permanent neurological damage after RA is extremely rare in the current anaesthetic practice.

We present a review of the literature on the incidence of complications following RA and their principal clinical pictures.

Spinal haematoma being one of the most feared complications, a deep discussion is devoted to the patients under antithrombotic drugs, including the new oral anticoagulants.


Regional anaesthesia Epidural anaesthesia Spinal anaesthesia Neurological deficit Antithrombotic drugs 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Edoardo De Robertis
    • 1
    Email author
  • Gennaro Scibelli
    • 2
  • Lucia Maio
    • 2
  1. 1.Unit of Obstetric and Gynecological Anaesthesia – AOU Federico IIUniversity of Napoli Federico IINaplesItaly
  2. 2.Department of Anaesthesiology and Intensive Care, Local Healthcare Unit “Naples 1”S. Paolo HospitalNaplesItaly

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