Researchers have called for a national database to be set up to identify major complications arising from epidural pain relief after a small number of serious problems were identified during a six-year UK study, according to the April issue of Anaesthesia.
They discovered that 12 of the 8,100 people studied developed major complications after receiving epidural pain relief following an operation. Six developed epidural abscesses, three suffered from meningitis and three had blood clots in the epidural space.
Twelve different anaesthetists sited the epidural catheters and the patients were managed on five different wards after surgery. All the epidural insertions met recommended aseptic techniques to minimise infection.
"Although relatively rare, these complications are serious and point to the need for regular surveys to be carried out after epidural pain relief to identify risk factors and the scale of the problem" says consultant anaesthetist Dr Iain Christie from Derriford Hospital, Plymouth, UK.
"For example, epidural abscesses can cause neurological damage and paralysis of the lower limbs if left untreated."
The survey which took place between 2000 and 2005 gathered information from four key sources.
Researchers looked at the hospital's patient information system to identify patients undergoing surgery and the acute pain service to identify all patients receiving epidural pain relief after surgery.
They also looked at any patients who had received a spinal MRI scan or undergone relevant microbiological investigations within 60 days of surgery.
Before they carried out the survey clinicians were aware of seven patients who had suffered major complications after epidural pain relief during the study period. The survey identified a further five.