Abstract
This chapter covers those complications that occur during performance of the block or within the first 24 hours thereafter. While most complications are minor, some are life threatening. Mulroy and colleagues recently published a review of the literature and recommendations to avoid some of these life-threatening complications from epidural injection of local anaesthetics.1
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Mulroy MF, Norris MC, Liu SS. Safety steps for epidural injection of local anesthetics: review of the literature and recommendations. Anesth Analg 1997; 85: 1346–56
Crawford JS. Some maternal complications of epidural analgesia for labour. Anaesthesia 1985; 40: 1219–25
Paech MJ, Godkin R, Webster S. Complications of obstetric epidural analgesia and anaesthesia: a prospective analysis of 10 995 cases. International Journal of Obstetric Anesthesia 1998; 7: 5–11
Scott DB, Tunstall ME. Serious complications associated with epidural/spinal blockade in obstetrics: a two-year prospective study. International Journal of Obstetric Anesthesia 1995; 4: 133–9
Scott DB, Hibbard BM. Serious non-fatal complications associated with extradural block in obstetric practice. Br J Anaesth 1990; 64: 537–41
Sinclair M, Simmons S, Cyna A. Incidents in obstetric anaesthesia and analgesia: an analysis of 5000 AIMS reports. Anaesth Intensive Care 1999; 27: 275–81
Morgan B. Unexpectedly extensive conduction blocks in obstetric epidural analgesia. Anaesthesia 1990; 45: 148–52
Blomberg RG. The lumbar subdural extraarachnoid space of humans: an anatomical study using spinalosopy in autopsy cases. Anesth Analg 1987; 66: 177–80
Mehta M, Maher R. Injection in the extra-arachnoid subdural space. Anaesthesia 1977; 32: 760–6
Reynolds F, Speedy HM. The subdural space: the third place to go astray. Anaesthesia 1990; 45: 120–3
Rowbottom SJ, Kong AS, Chan M, Tabrizian I. Subdural block. (Letter) Anaesth Intensive Care 1993; 21: 132–3
Howard R, Anderson W. Subdural catheterization and opiate administration in a patient with Harrington rods. (Letter) Can J Anaesth 1990; 37: 712
McMenemin IM, Sissons GA), Brownridge P. Accidental subdural catheterization: radiological evidence of a possible mechanism for spinal cord damage. Br J Anaesth 1992; 69: 417–9
Lubenow T, Keh-Wong E, Kristof K, Ivankovich O, Ivankovich AD. Inadvertent subdural injection: a complication of epidural block. Anesth Analg 1988; 67: 175–9
Collier CB. Accidental subdural block: four more cases and a radiographic review. Anaesth Intensive Care 1992; 20: 215–32
Miller DC, Choi WW, Chestnut DH. Subdural injection of local anesthetics and morphine. A complication of attempted epidural anesthesia. S Med J 1989; 82: 87–9
Manchanda VN, Murad SHN, Shilyansky G, Mehringer M. Unusual clinical course of accidental subdural local anesthetic injection. Anesth Analg 1983; 62: 1124–6
Collier CB, Gatt SP, Lockley SM. A continuous subdural block. Br J Anaesth 1993; 70: 462–5
Chadwick HS, Bernards CM, Kovarik DW, Tomlin N. Subdural injection of morphine for analgesia following cesarean section: a report of three cases. Anesthesiology 1992; 77: 590–4
Boys JE, Norman PF. Accidental subdural analgesia: a case report, possible clinical implications and relevance to “massive extradurals”. Br J Anaesth 1975; 47: 1111–3
Gershon RY. Surgical anaesthesia for caesarean section with a subdural catheter. Can J Anaesth 1996; 43: 1068–71
Lowenwirt I, Citron A, Krishnamurthy U. Successful subdural anesthesia for cesarean section and postoperative pain management. International Journal of Obstetric Anesthesia 1995; 4: 120–2
Massey Dawkins CJ. An analysis of the complications of extradural and caudal block. Anaesthesia 1969; 24: 554–63
Schultz Jr, EH, Brogdon BG. The problem of subdural placement in myelography. Radiology 1962; 79: 91–6
Jones MD, Newton TH. Inadvertent extra-arachnoid injections in myelography. Radiology 1963; 80:818–22
Richardson MG, Lee AC, Wissler RN. High spinal anesthesia after epidural test dose administration in five obstetric patients. Reg Anesth 1996; 21: 119–23
Hodgkinson R. Total spinal block after epidural injection into an interspace adjacent to an Madvertent dural perforation. Anesthesiology 1981; 55: 593–5
Leach A, Smith GB. Subarachnoid spread of epidural local anaesthetic following dural puncture. Anaesthesia 1988; 43: 671–4
Beck H, Brassow F, Doehn M, Bause H, Dziadzka A, Schulte am Esch J. Epidural catheters of the multi-orifice type: dangers and complications. Acta Anaesthesiol Scand 1986; 30: 549–55
Parker J, Balis N, Chester S, Adey D. Cardiopulmonary arrest in pregnancy: successful resuscitation of mother and infant following immediate caesarean section in labour ward. Aust NZ J Obstet Gynaecol 1996; 36: 207–10
Mehta M, Salmon N. Extradural block. Confirmation of the injection site by x-ray monitoring. Anaesthesia 1985; 40: 1009–12
Sala-Blanch X, Martinez-Palli G, Agusti-Lasus M, Nalda-Felipe MA. Misplacement of multihole epidural catheters-a report of two cases. Anaesthesia 1996; 51: 386–8
Stone PA, Thorburn J, Lamb KSR. Complications of spinal anaesthesia following extradural block for caesarean section. Br J Anaesth 1989; 62: 335–7
Blumgart CH, Ryall D, Dennison B, Thompson-Hill LM. Mechanism of extension of spinal anaesthesia by extradural injection of local anaesthetic. Br J Anaesth 1992; 69: 457–60
Beck GN, Griffiths AG. Failed extradural anaesthesia for caesarean section. Complication of subsequent spinal block. Anaesthesia 1992; 47: 690–2
Rutter JM, Lyons G. Subarachnoid block as an adjunct to extradural anaesthesia.(letter) Anaesthesia 1993; 48: 831–2
Mets B, Broccoli E, Brown AR. Is spinal anesthesia after failed epidural anesthesia contraindicated for Cesarean section. Anesth Analg 1993; 77: 629–31
Dell RG, Orlikowski CEP. Unexpectedly high spinal anaesthesia following failed extradural anaesthesia for caesarean section. Anaesthesia 1993; 48: 641
Gupta A, Enlund G, Bengtsson M, Sjöberg F. Spinal anaesthesia for caesarean section following epidural analgesia in labour: a relative contraindication. International Journal of Obstetric Anesthesia 1994; 3: 153–6
Waters JH, Leivers D, Hullander M. Response to spinal anesthesia after inadequate epidural anesthesia. (letter) Anesth Analg 1994; 78: 1033–4
Goldstein MM, Dewan DM. Spinal anesthesia after failed epidural anesthesia. (letter). Anesth Analg 1994; 79: 1206–7
Furst SR, Reisner LS. Risk of high spinal anesthesia following failed epidural block for cesarean delivery. J Clin Anesth 1995; 7: 71–4
Adams TJ, Peter EA, Douglas MJ. Is spinal anesthesia contraindicated after failed epidural anesthesia. (letter) Anesth Analg 1995; 81: 659
Stoneham M, Souter A. Spinal anaesthesia for caesarean section in women with incomplete extradural analgesia. (letter) Br J Anaesth 1996; 76: 476
Dennison B. A failed spinal following an epidural block. (letter) Anaesthesia 1982; 37: 348–9
Bromage PR. Epidural Analgesia. WB Saunders Company, Philadelphia. 1978 pp 659–60
Verniquet AJW. Vessel puncture with epidural catheters. Experience in obstetric patients. Anaesthesia 1980; 35: 660–2
Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. (Editorial) Anesthesiology 1979; 51: 285–7
McLean BY, Rottman RL, Kotelko DM. Failure of multiple test doses and techniques to detect intravascular migration of an epidural catheter. Anesth Analg 1992; 74: 454–6
Michael S, Richmond MN, Birks RJS. A comparison between open-end (single hole) and closed-end (three lateral holes) epidural catheters. Anaesthesia 1989; 44: 578–80
Morrison LMM, Buchan AS. Comparison of complications associated with single-holed and multi-holed extradural catheters. Br J Anaesth 1990; 64: 183–5
Banwell BR, Morley-Forster P, Krause R. Decreased incidence of complications with the Arrow (FlexTip PlusT“) epidural catheter. Can J Anaesth 1998; 45: 370–2
D’Angelo R, Foss ML, Livesay CH. A comparison of multiport and uniport epidural catheters in laboring patients. Anesth Analg 1997; 84: 1276–9
D’Angelo R, Berkebile BL, Gerancher JC. Prospective examination of epidural catheter insertion. Anesthesiology 1996; 84: 88–93
Wilson DJ, Douglas MJ. Neuraxial opioids in labour. Baillieres Clin Obstet Gynaecol 1998; 12: 363–76
Caplan RA, Ward RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 1988; 68: 5–11
Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992; 76: 906–16
Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complications related to regional anesthesia. Results of a prospective survey in France. Anesthesiology 1997; 87: 479–86
Juhani TP, Hannele H. Complications during spinal anesthesia for cesarean delivery: a clinical report of one year’s experience. Reg Anesth 1993; 18: 128–31
Hawthorne L, Lyons G. Cardiac arrest complicating spinal anaesthesia for caesarean section. International Journal of Obstetric Anesthesia 1997; 6: 126–9
Matta BF, Magee P. Wenckebach type heart block following spinal anaesthesia for caesarean section. Can J Anaesth 1992; 39: 1067–8
Thrush DN, Downs JB. Vagotonia and cardiac arrest during spinal anesthesia. Anesthesiology 1999; 91: 1171–3
Kinsella SM, Black AMS. Reporting of “hypotension” after epidural analgesia during labour. Effect of choice of arm and timing of baseline readings. Anaesthesia 1998; 53: 131–5
Defalque RJ. Compared effects of spinal and extradural anesthesia upon the blood pressure. Anesthesiology 1962; 23: 627–30
Rout CC, Rocke DA, Levin J, Gouws E, Reddy D. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section. Anesthesiology 1993; 79: 262–9
Murray AM, Morgan M, Whitwam JG. Crystalloid versus colloid for circulatory preload for epidural caesarean section. Anaesthesia 1989; 44: 463–6
Brizgys RV, Dailey PA, Shnider SM, Kotelko DM, Levinson G. The incidence and neonatal effects of maternal hypotension during epidural anesthesia for cesarean section. Anesthesiology 1987;67: 782–6
King SW, Rosen MA. Prophylactic ephedrine and hypotension associated with spinal anesthesia for cesarean delivery. International Journal of Obstetric Anesthesia 1998; 7: 18–22
Wollman SB, Marx GF. Acute hydration for prevention of hypotension of spinal anesthesia in parturients. Anesthesiology 1968; 29: 374–80
Riley ET, Cohen SE, Rubenstein AJ, Flanagan B. Prevention of hypotension after spinal anesthesia for cesarean section: six percent hetastarch versus lactated Ringer’s solution. Anesth Analg 1995; 81: 838–42
Olsen KS, Feilberg VL, Hansen CL, Rudkjobing O, Pedersen T, Kyst A. Prevention of hypotension during spinal anaesthesia for caesarean section. International Journal of Obstetric Anesthesia 1994; 3: 20–4
Datta S, Alper MH, Ostheimer GW, Weiss JB. Method of ephedrine administration and nausea and hypotension during spinal anesthesia for cesarean section. Anesthesiology 1982; 56: 68–70
Kang YG, Abouleish E, Caritis S. Prophylactic intravenous ephedrine infusion during spinal anesthesia for cesarean section. Anesth Analg 1982; 61: 839–42
Zamora JE, Rosaeg OP, Lindsay MP, Crossan ML. Haemodynamic consequences and uterine contractions following 0.5 or 1.0 litre crystalloid infusion before obstetric epidural analgesia. Can J Anaesth 1996; 43: 347–52
Collins KM, Bevan DR, Beard RW. Fluid loading to reduce abnormalities of fetal heart rate and maternal hypotension during epidural analgesia in labour. BMJ 1978; 2: 1460–1
Husaini SW, Russell IF. Volume preload: lack of effect in the prevention of spinal-induced hypotension at caesarian section. International Journal of Obstetric Anesthesia 1998; 7: 76–81
Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal-induced hypotension at caesarean section. Br J Anaesth 1995; 75: 262–5
Shearer VE, Ramin SM, Wallace DH, Gilstrap LC Ill. Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section. J Mat Fetal Med 1996; 5: 79–84
James FM III, Greiss FC, Kemp RA. An evaluation of vasopressor therapy for maternal hypotension during spinal anesthesia. Anesthesiology 1970; 33: 25–33
Ramanathan S, Grant GJ. Vasopressor therapy for hypotension due to epidural anesthesia for cesarean section. Acta Anaesthesiol Scand 1988; 32: 559–65
Moran OH, Perillo M, LaPorta RF, Bader AM, Datta S. Phenylephrine in the prevention of hypotension following spinal anesthesia for cesarean delivery. J Clin Anesth 1991; 3: 301–5
Collis RE, Baxandall ML, Srikantharajah ID, Edge G, Kadim MY, Morgan BM. Combined spinal epidural (CSE) analgesia: technique, management, and outcome of 300 mothers. International Journal of Obstetric Anesthesia 1994; 3: 75–81
Biousse V, Guevara RA, Newman NJ. Transient Homer’s syndrome after lumbar epidural anesthesia. Neurology 1998; 51: 1473–5
Sprung J, Haddox JD, Maitra-D’Cruze AM. Homer’s syndrome and trigeminal nerve palsy following epidural anaesthesia for obstetrics. Can J Anaesth 1991; 38: 767–71
Mohan J, Potter JM. Pupillary constriction and ptosis following caudal epidural analgesia. Anaesthesia 1975; 30: 769–73
Clayton KC. The incidence of Homer’s syndrome during lumbar extradural for elective caesarean section and provision of analgesia during labour. Anaesthesia 1983; 38: 583–5
Hertz R, Chiovari CA, Marx GF. Delayed Homer’s syndrome following obstetric extradural block. Anesth Analg 1980; 59: 299–300
Hanson AL, Hanson B, Matousek M. Epidural anesthesia for cesarean section. Acta Obstet Gynecol Scand 1984; 63: 135–40
Skaredoff MN, Datta S. Horner’s syndrome during epidural anaesthesia for elective caesarean section. Can Anaesth Soc J 1981; 28: 82–5
Schachner SM, Reynolds AC. Homer syndrome during lumbar epidural analgesia for obstetrics. Obstet Gynecol 1982; 59: S31–2
Evans JM, Gauci CA, Watkins G. Homer’s syndrome as a complication of lumbar epidural block. Anaesthesia 1975; 30: 774–7
Aya AGM, Mangin R, Robert C, Ferrer J-M, Eledjam J-J. Increased risk of unintentional dural puncture in night-time obstetric epidural anesthesia. Can J Anesth 1999; 46: 665–9
Naulty JS, Ostheimer GW, Datta S, Knapp R, Weiss JB. Incidence of venous air embolism during epidural catheter insertion. Anesthesiology 1982; 57: 410–2
Dunn SM, Steinberg RB, O’Sullivan PS, Goolishian WT, Villa EA. A fractured epidural needle: case report and study. Anesth Analg 1992; 75: 1050–2
Tio TO. Macmurdo SD. McKenzie R. Mishap with an epidural catheter. Anesthesiology 1979; 50:260–2
Bonica JJ, Backup PH, Anderson CE, Hadfield D, Crepps WF, Monk BF. Peiidural block: Analysis of 3637 cases and a review. Anesthesiology 1957; 18: 723–84
Chun L, Karp M. Unusual complications from placement of catheters in caudal canal in obstetrical anesthesia. Anesthesiology 1966; 27: 96–7
Hutchison GL. The severance of epidural catheters. Anaesthesia 1987; 42: 182–5
Hehre FW, Muechler HC. Complication associated with use of extradural catheter in obstetric anesthesia. Anesth Analg 1965; 44: 245–7
Browne RA, Politi VI.. Knotting of an epidural catheter: a case report. Can Anaesth Soc J 1979; 26: 142–4
Bromage PR. Epidural Analgesia. WB Saunders Company, Philadelphia 1978, pp230–1
Gozal D, Gozal Y, Beilin B. Removal of knotted epidural catheters. Case reports. Reg Anesth 1996; 21: 71–3
Blass NH, Roberts RB, Wiley JK. The case of the errant epidural catheter. Anesthesiology 1981; 54: 419–21
Jongleux EF, Miller R, Freeman A. An entrapped epidural catheter in a postpartum patient. Reg Anesth Pain Med 1998; 23: 615–7
Ravindran RS, Karuparthy VR. An entrapped epidural catheter in a postpartum patient. (letter) Reg Anesth Pain Med 1999; 24: 481
Boey SK, Carrie LES. Withdrawal forces during removal of lumbar extradural catheters. Br J Anaesth 1994; 73: 833–5
Munoz HR, Danino JA, Allende M, Bugedo GJ, Montes JM, Cherreds OG. Direction of catheter insertion and incidence of paresthesias and failure rate in continuous epidural anesthesia: a comparison of cephalad and caudad catheter insertion. Reg Anesth 1993; 18: 331–4
Rolbin SH, Hew E, Ogilvie G. A comparison of two types of epidural catheters. Can J Anaesth 1987; 34: 459–61
Scott DA, Beilby DS. Epidural catheter insertion: the effect of saline prior to threading in non-obstetric patients. Anaesth Intensive Care 1993; 21: 284–7
Rolbin SH, Halpern SH, Braude BM, Kapala D, Unger R, Radhakrisnan S. Fluid through the epidural needle does not reduce complications of epidural catheter insertion. Can J Anaesth 1990; 37: 337–40
Yoshii WY, Rottman RL, Rosenblatt RM, Kotelko DM, Rasmus KT, Rosen PJ, Wright WC, Stone JJ. Epidural catheter-induced traumatic radiculopathy in obstetrics. Reg Anesth 1994; 19: 132–5
Eappen S, Blinn A, Segal S. Incidence of epidural catheter replacement in parturients: a retrospective chart review. International Journal of Obstetric Anesthesia 1998; 7: 220–5
Collier CB. Why obstetric epidurals fail: a study of epidurograms. International Journal of Obstetric Anesthesia 1996; 5: 19–31
Hamilton CL, Riley ET, Cohen SE. Changes in the position of epidural catheters associated with patient movement. Anesthesiology 1997; 86: 778–84
Bishton IM, Martin PH, Vernon JM, Liu WHD. Factors influencing epidural catheter migration. Anaesthesia 1992; 47: 610–2
Crosby ET. Epidural catheter migration during labour: an hypothesis for inadequate analgesia. Can J Anaesth 1990; 37: 789–93
Holmstróm B, Rawal N, Axelsson K, Nydahl P-A. Risk of catheter migration during combined spinal epidural block: percutaneous epiduroscopy study. Anesth Analg 1995; 80: 747–53
Collier CB, Gatt SP. Epidural catheters for obstetrics. Terminal hole or lateral eyes? Reg Anesth 1994; 19: 378–85
Hogan Q. Epidural catheter tip position and distribution of injectate evaluated by computed tomography. Anesthesiology 1999; 90: 964–70
Morgan BM, Rehor S, Lewis PJ. Epidural analgesia for uneventful labour. Anaesthesia 1980; 35: 57–60
Beilin Y, Zahn J, Bernstein HH, Zucker-Pinchoff B, Zenzen WJ, Andres LA. Treatment of incomplete analgesia after placement of an epidural catheter and administration of local anesthetic for women in labor. Anesthesiology 1998; 88: 1502–6
DeKrey JA. To the editor. (letter) Anesth Analg 1973; 52: 218–9
Rainbird A, Pfitzner J. Restricted spread of analgesia following epidural blood patch. Anaesthesia 1983; 38: 481–4
Crawford JS. Epidural blood patch. (letter) Anaesthesia 1985; 40: 381
Ong BY, Graham CR, Ringaert KRA Cohen MM, Palahniuk RJ. Impaired epidural analgesia after durai puncture with and without subsequent blood patch. Anesth Analg 1990; 70: 76–9
Hebl JR, Horlocker TT, Chantigian RC, Schroeder DR. Epidural anesthesia and analgesia are not impaired after dural puncture with or without epidural blood patch. Anesth Analg 1999; 89: 390–4
Blanche R, Eisenach JC, Tuttle R, Dewan DM. Previous wet tap does not reduce success rate of labor epidural analgesia. Anesth Analg 1994; 79: 291–4
Jaameri KEU, Jahkola A, Perttu J. On shivering in association with normal delivery. Acta Obstet Gynecol Scand 1966; 45: 383–388
Brownridge P. Shivering related to epidural blockade with bupivacaine in labour, and the influence of epidural pethidine. Anaesth Intensive Care 1986; 14: 412–7
Ostheimer GW, Datta S. Observations in the postpartum recovery room after various local anesthetic techniques. Reg Anesth 1981; 6: 13–7
Webb PJ, James FM, Wheeler AS. Shivering during epidural analgesia in women in labor. Anesthesiology 1981; 55: 706–7
Kapusta L, Confino E, Ismajovich B, Rosenblum Y, David MP. The effect of epidural analgesia on maternal thermoregulation in labor. Int J Gynaecol Obstet 1985; 23: 185–9
Gleeson NC, Nolan KM, Ford MRW. Temperature, labour, and epidural analgesia. (letter) Lancet 1989; 2: 861–2
Ponte J, Collett BJ, Walmsley A. Anaesthetic temperature and shivering in epidural anaesthesia. Acta Anaesthesiol Scand 1986; 30: 584–7
Casey WF, Smith CE, Katz JM, O’Loughlin K, Weeks SK. Intravenous meperidine for control of shivering during caesarean section under epidural anaesthesia. Can J Anaesth 1988; 35: 128–33
Bay J, Nunn JF, Prys-Roberts C. Factors influencing arterial PO2 during recovery from anaesthesia. Br J Anaesth 1968; 40: 398–407
De Courcy JG. Artefactual “hypotension’ from shivering. (letter) Anaesthesia 1989; 44: 787–8
Bowes WA 3d, Corke BC, Hulka J. Pulse oximetry: a review of the theory, accuracy, and clinical applications. Obstet Gynecol 1989; 74: 541–6
Sessler DI, Ponte J. Shivering during epidural anesthesia. Anesthesiology 1990; 72: 816–21
Hynson JM, Sessler DI, Glosten B, McGuire J. Thermal balance and tremor patterns during epidural anesthesia. Anesthesiology 1991; 74: 680–90
Panzier O, Ghazenfari N, Sessler DI, et al. Shivering and shivering-like tremor during labor with and without epidural analgesia. Anesthesiology 1999; 90: 1609–16
Shehabi Y, Gatt S, Buckman T, Isert P. Effect of adrenaline, fentanyl and warming of injectate on shivering following extradural analgesia in labour. Anaesth Intensive Care 1990; 18: 31–7
Walmsley AJ, Gieseke AH, Lipton JM. Contribution of extradural temperature to shivering during extradural anaesthesia. Br J Anaesth 1986; 58: 1130–4
Ponte J, Sessler DI. Extradurals and shivering: effects of cold and warm extradural saline injections in volunteers, Br J Anaesth 1990; 64: 731–3
Harris MM, Lawson D, Cooper CM, Ellis J. Treatment of shivering after epidural lidocaine. Reg Anesth 1989; 14: 13–8
Fruhstorfer H, Zenz M, Nolte H, Hensel H. Dissociated loss of cold and warm sensibility during regional anaesthesia. Pflugers Arch - Eur J Physiol 1974; 349: 73–82
Emerick TH, Ozaki M, Sessler DI, Walters K, Schroeder M. Epidural anesthesia increases apparent leg temperature and decreases the shivering threshold. Anesthesiology 1994; 81: 289–98
Slinger PD, Bevan DR, Smith JB, Weeks SK. Shivering during epidural anaesthesia for caesarean section. Can Anaesth Soc J 1984; 31: S81–2
Glosten B, Sessler DI, Ostman LG, Faure EAM, Karl L, Thisted RA. Intravenous lidocaine does not cause shivering-like tremor or alter thermoregulation. Reg Anesth 1991; 16: 218–22
Ozaki M, Kurz A, Sessler DI, Lenhardt R, Schroeder M, Moayeri A, Noyes KM, Rotheneder E. Thermoregulatory thresholds during epidural and spinal anesthesia. Anesthesiology 1994; 81: 282–8
Mehta P, Theriot E, Mehrotra D, Patel K, Zarbalian A. Shivering following epidural anesthesia in obstetrics. Reg Anesth 1984; 9: 83–5
Workhoven MN. Intravenous fluid temperature, shivering, and the parturient. Anesth Analg 1986; 65: 496–8
McCarroll SM, Cartwright P, Weeks SK, Donati F. Warming intravenous fluids and the incidence of shivering during caesarean sections under epidural anaesthesia. Can Anaesth Soc J 1986; 33: S72–S73
Chan VWS, Morley-Foster PK, Vosu HA. Temperature changes and shivering after epidural anesthesia for cesarean section. Reg Anesth 1989; 14: 48–52
Chan AMH, Ng KFJ, Tong EWN, Jan GSK. Control of shivering under regional anesthesia in obstetric patients with tramadol. Can J Anesth 1999; 46: 253–258
Matthews NC, Corser G. Epidural fentanyl for shaking in obstetrics. Anaesthesia 1988; 43: 783–5
Liu WHD, Luxton MC. The effect of prophylactic fentanyl on shivering in elective caesarean section under epidural analgesia. Anaesthesia 1991; 46: 344–8
Sutherland J, Seaton H, Lowry C. The influence of epidural pethidine on shivering during lower segment caesarean section under epidural anaesthesia. Anaesth Intensive Care 1991; 19: 228–32
Sevarino FB, Johnson MD, Lema MJ, Datta S, Ostheimer GW, Naulty JS. The effect of epidural sufentanil on shivering and body temperature in the parturient. Anesth Analg 1989; 68: 530–3
Capogna G, Celleno D. I.V. clonidine for post-extradural shivering in parturients: a preliminary study. Br J Anaesth 1993; 71: 294–5
Mercadante S, De Michele P, Letterio G, Pignataro A, Sapin M, Villari P. Effect of clonidine on postpartum shivering after epidural analgesia: a randomized, controlled, double-blind study. J Pain Symptom Management 1994; 9: 294–7
Sia S. I.V. clonidine prevents post-extradural shivering. Br J Anaesth 1998; 81: 145–6
O’Meara ME, Gin T. Comparison of 0.125% bupivacaine with 0.125% bupivacaine and clonidine as extradural analgesia in the first stage of labour. Br J Anaesth 1993; 71: 651–6
Negishi C, Ozaki M, Sessler DI, Matsukawa T, Suzuki H, Ozaki K, Atarashi K. Forced-air warming prevents shivering during Cesarean delivery with epidural anesthesia. Anesth Analg 1997; 84: S398
Sharkey A, Lipton JM, Murphy MT, Giesecke AH. Inhibition of postanesthetic shivering with radiant heat. Anesthesiology 1987; 66: 249–52
Buggy D, Gardiner J. The space blanket and shivering during extradural analgesia in labour. Acta Anaesthesiol Scand 1995; 39: 551–3
Goodlin RC, Chapin JW. Determinants of maternal temperature during labor. Am J Obstet Gynecol 1982; 143: 97–103
Marx GF, Loew DAY. Tympanic temperature during labour and parturition. Br J Anaesth 1975; 47: 600–2
Karambelkar D, Ramanathan MD. Speed of labor influences maternal temperature rise during epidural analgesia. Anesth Analg 1998; 86: S376
Holdcroft A, Hall GM, Cooper GM. Redistribution of body heat during anaesthesia. Anaesthesia 1979; 34: 758–64
Matsukawa T, Sessler DI, Christensen R, Ozaki M, Schroeder M. Heat flow and distribution during epidural anesthesia. Anesthesiology 1995; 83: 961–7
Larue F, Benhamou D, Jullien P, Labaille T, Champagne C. Temperature monitoring during epidural anesthesia for cesarean delivery. Reg Anesth 1991; 16: 322–4
Saito T, Sessler DI, Fujita K, Ooi Y, Jeffrey R. Thermoregulatory effects of spinal and epidural anesthesia during cesarean delivery. Reg Anesth Pain Med 1998; 23: 418–23
Fusi L, Steer PJ, Maresh MJA, Beard RW. Maternal pyrexia associated with the use of epidural analgesia in labour. Lancet 1989; 1: 1250–2
Camann WR, Hortvet LA, Hughes N, Bader AM, Datta S. Maternal temperature regulation during extradural analgesia for labour. Br J Anaesth 1991; 67: 565–8
Macaulay JH, Bond K, Steer PJ. Epidural analgesia in labour and fetal hyperthermia. Obstet Gynecol 1992; 80: 665–9
Vinson DC, Thomas R, Kiser T. Association between epidural analgesia during labor and fever. J Fam Pract 1993; 36: 617–22
Birnbach DJ, Stein DJ, Hartman JK, Dancer BI, Grunebaum A. Is maternal fever associated with the administration of regional anesthesia in laboring patients? Anesthesiology 1996; 85: A899
Philip J, Alexander JM, Sharma SK, Leveno KJ, McIntire DD, Wiley J. Epidural analgesia during labor and maternal fever. Anesthesiology 1999; 90: 1271–5
Mercier FJ, Benhamou D. Hyperthermia related to epidural analgesia during labor. International Journal of Obstetric Anesthesia 1997; 6: 19–24
Herbst A, Wolner-Hanssen P. Ingemarsson I. Risk factors for fever in labor. Obstet Gynecol 1995; 86: 790–4
Thomas ML, Yentis SM, Barnes P. Maternal temperature during labour using low-dose (ambulatory) epidural analgesia with bupivacaine and fentanyl. International Journal of Obstetric Anesthesia 1998; 7: 108–10
Mayer DC, Chescheir NC, Spielman FJ. Increased intrapartum antibiotic administration associated with epidural analgesia in labor. Am J Perinatol 1997; 14: 83–6
Camann WR. Epidural analgesia in labor and fetal hyperthermia. (letter) Obstet Gynecol 1993; 81: 316
Lieberman E, Lang JM, Frigoletto F, Richardson DK, Ringer SA, Cohen A. Epidural analgesia, intrapartum fever, and neonatal sepsis evaluation. Pediatrics 1997; 99: 415–9
Wang CY, Ong GSY. Severe bronchospasm during epidural anaesthesia. Anaesthesia 1993; 48: 514–5
Mallampati SR. Bronchospasm during spinal anesthesia. Anesth Analg 1981; 60: 839–40
Zeidel A, Gingold A, Satunovsky E, Harow EE, Beilin B-Z. Bedside test for diagnosis of oedema fluid after extradural anaesthesia. Can J Anaesth 1998; 45: 664–6
Ennis M, Brock-Utne JG. Delayed cutaneous fluid leak from the puncture hole after removal of an epidural catheter. Anaesthesia 1993; 48: 317–8
Downey L, Slater EM, Zeitlin GL. Differentiating interstitial fluid from cerebral spinal fluid (Letter). Anesthesiology 1985; 63: 120
Kirby IJ, Ryan TDR. Generalised oedema and epidural anaesthesia (Letter). Anaesthesia 1985; 40: 709–10
Forestner JE, Raj PP. Inadvertent epidural injection of thiopental: a case report. Anesth Analg 1975; 54: 406–7
Cay DL. Accidental epidural thiopentone. Anaesth Intensive Care 1984; 12: 61–3
Fukuda T, Sato S, Takahashi S, Kumagai M, Naito H. Unintentional epidural administration of thiamylal. Case report. Reg Anesth 1994; 19: 412–4
Wells D, Davies G, Wagner D. Accidental injection of epidural methohexital. Anesthesiology 1987; 67: 846–8
Shanker KB, Palkar NV, Nishkala R. Paraplegia following epidural potassium chloride. Anaesthesia 1985; 40: 45–7
Lin D, Becker K, Shapiro HM. Neurologic changes following epidural injection of potassium chloride and diazepam: a case report with laboratory correlations. Anesthesiology 1986; 65: 210–2
Tessler MJ, White I, Naugler-Colville M, Biehl DR. Inadvertent epidural administration of potassium chloride: a case report. Can J Anaesth 1988; 35: 631–3
Liu K, Chia Y-Y. Inadvertent epidural injection of potassium chloride. Report of two cases. Acta Anaesthesiol Scand 1995; 39: 1134–7
Vercauteren M, Saldien V. Epidural injection of potassium hydrochloride. (letter) Acta Anaesthesiol Scand 1996; 40: 505
do Nascimento Jr P. Modolo NSP, Meletti JFdA, Bras JRC. Sympathetic hyperactivity, respiratory failure, pruritus, and anesthesia after unintentional epidural injection of potassium chloride: case report. Reg Anesth Pain Med 1998; 23: 219–22
McGuinness JP, Cantees KK. Epidural injection of a phenol-containing ranitidine preparation. Anesthesiology 1990; 73: 553–5
Kopacz DJ, Slover RB. Accidental epidural cephazolin injection: Safeguards for patient-controlled analgesia. Anesthesiology 1990; 72: 944–7
Mappes A, Schaer HM. Accidental injection of ether into the epidural space. Anaesthesia 1991;46: 124–5
Loderer J, Suppan P. Accidental injection of ephedrine into the epidural space. (letter) Anaesthesia 1979; 34: 78–9
Dror A, Henriksen E. Accidental epidural magnesium sulfate injection. Anesth Analg 1987; 66: 1020–1
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag London
About this chapter
Cite this chapter
Douglas, J., Choi, D. (2000). Immediate complications of regional blockade in obstetrics. In: Reynolds, F. (eds) Regional Analgesia in Obstetrics. Springer, London. https://doi.org/10.1007/978-1-4471-0435-3_24
Download citation
DOI: https://doi.org/10.1007/978-1-4471-0435-3_24
Publisher Name: Springer, London
Print ISBN: 978-1-4471-1142-9
Online ISBN: 978-1-4471-0435-3
eBook Packages: Springer Book Archive