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EPIDURAL IN OBSTETRICS: IS IT SAFE?
ESRA Academy. Goncalves B. Sep 8, 2016; 138391; 0233 Topic: REGIONAL ANAESTHESIA (RA) IN SPECIFIC SUBPOPULATIONS
Ms. Bruna Goncalves
Ms. Bruna Goncalves

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Abstract
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Background and Aims:

Epidural technique is the gold standard of obstetrics anesthesia. Despite a relatively safe procedure, it can result in complications with consequences to the pregnant women and the fetus. The aim was to report our daily routine in obstetrics anesthesia and evaluate the incidence of adverse events.

Methods:

Retrospective cohort study. Data collected from all epidural catheters placed for labor analgesia or cesarean section over an 8-month period with a 3-month complication follow-up. We used SPSS® for descriptive statistics. Results are presented as percentage and average ± standard deviation.

Results:

A total of 687 patients were reviewed, 31,4±5,2 year-old, 97,7% ASA II. 79,5% of the epidural catheters were placed for labor analgesia, 13,4% for cesarean section and 7,1% for post-caesarean analgesia.
85% of the catheters were inserted without immediate complications. 4,9% complained of paresthesia in the leg when introducing the catheter, 5,4% had a bloody tap and 1,3% were technically difficult (ex.:multiple attempts). 2 women complained of lumbar pain during placement. There were 4 cases of accidental exteriorization with need of replacement.
For labor analgesia, 2,2% of women had insufficient or lateralization of analgesia. There was 1 accidental dural puncture that resulted in a postdural puncture headache. Conservative treatment was successfully started.
Ten days after discharge, 1 mother referred mild lumbar pain that resolved within days with no need for complementary exams.
There were no complications after 3 months.

Conclusions:

Our results were similar to the literature. There were no major complications that jeopardize the mother or the fetus’ outcomes, reinforcing the importance of epidural in obstetrics.

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