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Original Article
Extensive Application of Epidural Anesthesia and Analgesia in a University Hospital: Incidence of Complications Related to Technique
  1. Keiichi Tanaka, M.D.*,
  2. Ryuiku Watanabe, M.D.**,
  3. Toshiaki Harada, M.D.** and
  4. Kenjiro Dan, M.D.†
  1. A part of the content of this article was presented at the Annual Meeting of the Canadian Anaesthetists' Society, Vancouver, Canada, June 18, 1990, and at the Third Sino-Japanese Symposium on Clinical Anesthesiology, Wuhan, China, November 10, 1991.
  2. From the Department of Anesthesiology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-01, Japan.
  3. *Associate Professor.
  4. **Assistant Professor
  5. †Professor and Chairman.
  1. Address reprint requests to Keiichi Tanaka, M.D., Department of Anesthesiology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka 814-01, Japan.

Abstract

Background and Objectives. 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.

Methods. 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.

Results: 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%).

Conclusions: 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.

  • epidural
  • complications
  • bupivacaine
  • lidocaine
  • mepivacaine.

http://dx.doi.org/10.1136/rapm-00115550-199318010-00007

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    Footnotes

    • The authors thank Dr. A. H. Giesecke, Professor and Chairman, Department of Anesthesiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, for reviewing the manuscripts.