Navigation Links
Medical study shows epidurals and spinal anesthetics are safer than previously reported
Date:1/12/2009

The largest ever prospective study [1,2] into the major complications [3] of epidurals and spinal anaesthetics published in the British Journal of Anaesthesia today (Monday 12 January 2009) concludes that previous studies have over-estimated the risks of severe complications of these procedures. The study concludes that the estimated risk of permanent harm following a spinal anaesthetic or epidural is lower than 1 in 20,000 and in many circumstances the estimated risk is considerably lower.

The study finds that the risk of permanent injury (of whatever severity) is about 1 in 23-50,000. In betting terms, the odds of being badly injured by an epidural or spinal anaesthetic 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. The risk for women requiring pain relief for labour or Caesarean section is lower still, the most pessimistic estimate of permanent harm is 1 in 80,000 and it may be much lower. A similarly low risk was found in procedures performed for chronic pain and in children.

The study also finds that the risk of harm when an epidural is used for surgery is considerably higher than the estimated risk of using it during childbirth: between 1 in 6,000 and 1 in 12,000. However, while these figures may appear high, they too are still considerably lower than many previous estimates, and Dr Tim Cook, a consultant anaesthetist at the Royal United Hospital, Bath who led the project believes there are other reasons to explain these figures: "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. Major surgery leads to severe pain and may mean that an epidural has to stay in place for several days. Epidurals are generally only used for the biggest most painful operations and it is probably the least fit patients who have the most to gain from these techniques. What the project has shown is that many complications of epidurals occur after major surgery in elderly unhealthy patients. The risks must also be balanced against the generally accepted benefits of epidurals."

The project's results are based on the voluntary participation of every hospital in England, Scotland, Wales and Northern Ireland. A national census identified over 700,000 spinals and epidurals performed in the UK National Health Service each year. All major complications of these procedures were identified by the project team for one year. Each complication was reviewed by an expert panel, which assessed the cause and severity of all permanent injuries. In the year of the study, depending on interpretation, there were 14-30 patients who suffered permanent injury: injuries ranging from numbness in a part of the legs to paraplegia or death. Of the harmed patients 5-13 were paralysed and 3-6 died. Most complications were judged to be unavoidable.

Dr Tim Cook says, "The results are reassuring for patients with all procedures and settings being lower risk than many previous estimates. It is likely that this study will become widely quoted as the definitive estimate of these rare but potentially catastrophic complications."

However, Dr Cook believes anaesthetists should not be complacent: "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. For instance, it is likely that the number of complications could be further reduced by a greater appreciation that prolonged weakness of the legs after an epidural or spinal is not normal and should be investigated by an experienced doctor to ensure a major complication is not developing."

Writing in an editorial that accompanies the paper in the British Journal of Anaesthesia, Dr Donal Buggy, a consultant anaesthetist at the Mater Hospital, Dublin, describes the report as, "a triumph not only for its authors and the NHS anaesthetists who delivered it, but also for UK NHS risk management systems, audit databases, and processes." Dr Buggy asserts that "the primary achievement of the project is that it enables anaesthetists and patients to more accurately define the risk of the specific rare but devastating complications of these procedures."


'/>"/>

Contact: Dr Tim Cook
tcook@rcoa.ac.uk
44-079-700-25209
Oxford University Press
Source:Eurekalert

Related medicine news :

1. MSU engineering team designs innovative medical device
2. ATS Medical to Present at the 2007 Thomas Weisel Partners Healthcare Conference
3. Providence St. Joseph Medical Center, Caregivers Reach Agreement on a Union Contract
4. Owner and Operator of Florida Durable Medical Equipment Company Convicted of Medicare Fraud
5. Father and Daughter From Tanzania Receive Their First Medical Examination in Newport Beach
6. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
7. Preparation for Natural Disasters Critical for People With Diabetes, Chronic Medical Conditions
8. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
9. Symmetry Medical Completes Acquisition Of Specialty Surgical Instruments
10. Milestone Scientific Announces Successful Completion of its Collaboration Agreement With Carticept Medical
11. FDA Seeks to Regulate Complementary and Alternative Medicine; Products Such as Vegetable Juice Could Be Restricted for Medical Use
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... , ... On June 10-11, 2016, A Forever Recovery, a holistic treatment center ... Breakfast Table in Battle Creek, MI, where the rehabilitation facility is located. This annual ... the world’s leading providers of cereal and other breakfast foods. Its residents often refer ...
(Date:6/25/2016)... , ... June 25, 2016 , ... ... policy issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at ... on several important health care topics including advance care planning, healthcare costs and ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. ... his M.D from the David Geffen School of Medicine at UCLA. He trained in ... to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Those who have ... these feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as ... Michigan, has released tools for healthy coping following a traumatic event. , Trauma sufferers ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all ... brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 23, 2016 Research and Markets has ... 52" report to their offering. ... creates a favourable commercial environment for MedImmune to enter. The ... that will serve to drive considerable growth for effective anti-influenza ... to cap sales considerably, but development is still in its ...
(Date:6/23/2016)... PARK RIDGE, Ill. and INDIANAPOLIS ... caliber of students receiving a Lilly Diabetes Tomorrow,s Leaders ... hands. The 2016 scholarship winners, announced today online at ... refused to let type 1 diabetes stand in the ... Lilly Diabetes has supported the Foundation,s scholarship program since ...
(Date:6/23/2016)... N.J. , June 23, 2016  Guerbet announced ... Premier Inc.,s Supplier Horizon Award . ... year, Guerbet was recognized for its support of Premier ... creation through clinical excellence, and commitment to lower costs. ... to receive this recognition of our outstanding customer service ...
Breaking Medicine Technology: