Extensive application of epidural anesthesia and analgesia in a university hospital: incidence of complications related to technique.

Abstract

The authors report the role of epidural anesthesia and analgesia (EAA) and the incidence of epidural puncture-related complications in a university hospital in Japan. Epidural anesthesia and analgesia was the major (39.7%) technique when administering 40,010 anesthetics. For the upper and the lower abdominal procedures, EAA was the major anesthetic technique in 79.5%, and 71.1% of these were carried out without potent inhaled anesthetics or long-acting muscle relaxants, and without endotracheal intubation. Epidural anesthesia and analgesia-related complications included failure to produce anesthesia on the first attempt (4.1%), bleeding/intravascular cannulation (0.67%), unintentional dural puncture (0.61%), paresthesia (0.16%), and local anesthetic toxicity (0.12%). The incidence of EAA-related complications was greater with lumbar than with thoracic puncture. Four patients had transient neuropathy related to epidural puncture, but no serious neurologic complications occurred.