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Complications of epidural anesthesia

Epidural anesthesia is the anesthesia which blocks the pain in specific area of the body. The drugs that are administered have the goal to reduce the pain and sensations in the lower part of the body. As any other form of anesthesia epidural anesthesia carries certain risks. The most frequent side effect of the epidural anesthesia is the  hypotension. The Hypotension is corrected with fluids and vasopressors which are given intravenously. If excessive dosage of local anesthetics is given to inadvertent then the high epidural block may develop. Its features are with the low blood pressure, nausea, loss of sensation in chest region or even in an arms. This severe complication can even affect the breathing. The outcome may include securing of the airway and prompt treatment of hypotension. Local anesthetic toxicity may develop as a consequence of surpassing of the dose of anesthetics. Toxicity may happen even in case when proper dose is not given but straight into a blood vessel. This condition can be present with ringing in the ears, dizziness or even lead to coma and cardiopulmonary arrest.

If the epidural catheter accidentally ends within the subarachnoid space infrequent complication called total spine occurs. Patient is hypertensive and loses consciousness. The pupils are dilated and apnea occurs. The treatment of this severe complication includes intubation. The patient is administered 100% oxygen. The Intravenous fluids and vasopressors are given to correct the low blood pressure.

An accidental dural puncture may happen during the procedure of applying epidural anesthetics. It results in headache which is basically in the front of the skull. The pain is increased by movements or in a sitting or standing position. Nausea and vomiting may occur as well. Photophobia or sensitivity to light in a common sign. Epidural hematoma is disastrous complication of the procedure. It happens rarely and if it does occur the hematoma puts the pressure on the spinal cord. This condition may lead to paraplegia or complete paralysis of legs and the lower part of the body. Infectious agents may be carried into the epidural space if the catheter is contaminated. This is why the procedure has to be done in complete aseptic conditions. The presence of pathogens may lead to meningitis and epidural abscesses. The doctor who performs the procedure has to be experienced enough. It may happen that catheter ends up not within the epidural space but in other area. This results in failure of anesthetic effects. Sometimes segmental sparing happens due to anatomic differences among people. This leads to inadequate anesthesia of some nerve roots while others are numbed properly.

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