Complications of Obstetric Regional Anesthesia

  • Paul J. O’Connor


The major trend in the provision of anesthesia services to pregnant women over the past 25 years has been the increasing use of regional anesthetic techniques for labor and operative delivery.1 According to the latest report on Confidential Enquiries into Maternal Deaths in the United Kingdom, at least 80% of cesarean deliveries are now performed under regional block.2 The report highlights that the likelihood of dying from anesthesia is now 1 per 100,000 cesarean deliveries, more than 30 times less than it was during the 1960s. This reduction in mortality is clearly associated with the increased use of regional anesthesia, to which no deaths were attributed in this triennium.2 This was not always the case, and it is only 15 years since deaths resulting from regional anesthesia in the United States were evenly divided between local anesthetic toxicity and high spinal/epidural anesthesia.3 In contrast to regional anesthesia, the safety of general anesthesia remains unchanged since 1982–1984, and the risk of death attributable to general anesthesia is now estimated to be 1 death per 20,000 cesarean deliveries.2 Death is only the tip of the morbidity iceberg, however, and obstetric regional anesthesia was the source of more than one-third of anesthesia malpractice insurance claims in the United States during the 1980s and 1990s.4,5 Obstetric anesthetists must be familiar with the differential diagnosis of postpartum injuries to be able to recognize rare but potentially life-threatening complications of regional anesthesia. Such injuries may be intrinsic to labor and delivery or they may result directly or indirectly from obstetric or an esthetic intervention.6


Cesarean Delivery Epidural Analgesia Regional Anesthesia Placenta Previa Epidural Abscess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Paul J. O’Connor
    • 1
  1. 1.Department of AnesthesiaLetterkenny General HospitalLetterkenny, County DonegalIreland

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