Epidurals and Spinal Anesthetics Safer than Previously Thought

January 16, 2009
Shivani Parmar, MPH

A new study examined the major complications of epidurals and spinal anesthetics and found that previous studies overestimated the risks of these procedures.

A new study published in the British Journal of Anaesthesia examined the major complications of epidurals and spinal anesthetics and found that previous studies overestimated the risks of these procedures.

Described as the largest prospective study ever conducted, with voluntary participation from every hospital in England, Wales, Scotland, and Northern Ireland, the researchers reviewed more than 700,000 spinal anesthetic procedures and epidurals conducted by the UK National Health Service. Scientists identified the major complications that resulted from all central neuraxial block procedures performed during the one-year study period. During this time, depending on how the data was interpreted, 14-30 patients had a permanent injury, which ranged from numbness in the legs to paraplegia or death, and the complications were deemed as unavoidable.

Overall, researchers found the risk of permanent injury to be about 1 in 23-50,000. “In betting terms, the odds of being badly injured by an epidural or spinal anaethetic are considerably better than 20,000-to-1 against. The risk of being paralysed by one of these injections is 2-3 times rarer than of suffering any permanent harm.”

In addition, researchers determined that the risk of harm from an epidural administered during surgery is much higher than from an epidural administered during childbirth.

Lead researcher Tim Cook, MD, explained that “It has been known for a long time that these complications occur more often after surgery. The reason is likely to be that many of these patients are elderly with medical problems and that the process of having surgery itself increases risks.”

Cook also noted that the “results are reassuring for patients with all procedures and settings being lower risk than many previous estimates… Although complications related to epidurals are rare, the profession still needs to examine how and why these complications arise and make steps to reduce their frequency.”

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