Epidural anesthesia complications
This is a video on complications of epidural anesthesia.
This video was made using Google Slides.
Graphics were created or adapted from Wikimedia Commons.
ADDITIONAL TAGS:
Disease:
Pathophys:
Signs / symptoms:
Treatment / management:
Local anesthetic systemic toxicity
Catheter goes into epidural vasculature (systemic circulation) → CNS overactivity
Perioral numbness, metallic taste, tinnitus, seizures; tachycardia, hypertension
Stop the drug! Benzodiazepine for seizure control; supportive care
Epidural- associated hypotension
Epidural blocks sympathetic nerve (sympathetic blockage) → vasodilation, venous pooling → hypotension, tachycardia
Systemic hypotension (lightheadedness), compensatory tachycardia
If pregnant, left uterine placement (lay on left side); vasopressors (phenylephrine, ephedrine)
Inadvertent
spinal block;
"high spinal";
total spinal anesthesia
Local anesthesia pictures dura → ascends upwards in subarachnoid space → depression of cervical spinal cord and brainstem activity
Hypotension, bradycardia, complete motor blockage below lower thoracic spinal levels (diaphragm paralysis); dyspnea/apnea; hypoxemia; difficulty swallowing/speaking
-Stop the epidural infusion immediately
-Supportive: vasopressors, intubation
-Positioning: reverse Trendelenburg to decrease ascending anesthetic
Postdural puncture headache
Unintentional dural puncture during placement of neuraxial anesthesia → headache within 72 hours of procedure
Positional headache (worse when upright, improves when supine); stiff neck; n/v photophobia; diplopia; hearing loss/tinnitus
Supportive; +/- epidural blood patch
Epidural complications
spinal cord
pia mater
arachnoid mater
subarachnoid space
dura mater
epidural space
vertebral
bones
interspinous
ligaments
ligamentum flavum
Пікірлер: 7
Videos like this would be extremely helpful as presentations for Informed Consent. Were I to view this in considering an epidural anesthesia, I would decline.
You forgot to mention the worst complication, chronic Adhesive Arachnoiditis of the spinal cord leading to pain so severe many do not live long.
Thank you very much for your work! U are making very informative and compressed videos and it helps a lot)
Very helpful presentation thank you
Could you do a video on adhesive arachnoiditis from anesthesia epidurals
I’ve had 5 children all epidurals and no complications. When I had my 6th baby they gave me a epidural but as soon as I laid back I couldn’t breath and felt like I was choking. Every time I laid back I could not breath. I literally was taken to a emergency c section and I completely stopped breathing so I had to be resuscitated. They couldn’t figure out what was wrong with me and the anesthesiologist finally came in and told me that my spinal was to “flimsy” that’s why the epidural traveled up. I think she went in too far and now after seeing this I know she went in too far.
I had an epidural for 2 pregnancies and had bad reactions to both of them. First one I went into seizures and had hypotension but the 2nd one was better. Still had severe hypotension but they gave me drugs to stabilize my blood pressure.