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

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

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