Medizin - Open Access LMU - Teil 19/22

Incidence and predictors of immediate complications following perioperative non-obstetric epidural punctures


Listen Later

Background: Epidural Anesthesia (EA) is a well-established procedure. The aim of the present study was to evaluate the incidence of immediate complications following epidural puncture, such as sanguineous puncture, accidental dural perforation, unsuccessful catheter placement or insufficient analgesia and to identify patient and maneuver related risk factors. Methods: A total of 7958 non-obstetrical EA were analyzed. The risk of each complication was calculated according to the preconditions and the level of puncture. For probabilistic evaluation we used a logistic regression model with forward selection. Results: The risk of sanguineous puncture (n = 247, 3.1%) increases with both the patient's age (P = 0.013) and the more caudal the approach (P < 0.01). Dural perforation (n = 123, 1.6%) was found to be influenced only by advanced age (P = 0.019). Unsuccessful catheter placement (n = 68, 0.94%) occurred more often in smaller individuals (P < 0.001) and at lower lumbar sites (P < 0.01). Amongst all cases with successful catheter placement a (partial) insufficient analgesia was found in 692 cases (8.8%). This risk of insufficient analgesia decreased with patient's age (P < 0.01), being least likely for punctures of the lower thoracic spine (P < 0.001). Conclusions: Compared to more cranial levels, EA of the lower spine is associated with an increased risk of sanguineous and unsuccessful puncture. Insufficient analgesia more often accompanies high thoracic and low lumbar approaches. The risk of a sanguineous puncture increases in elderly patients. Gender, weight and body mass index seem to have no influence on the investigated complications.
...more
View all episodesView all episodes
Download on the App Store

Medizin - Open Access LMU - Teil 19/22By Ludwig-Maximilians-Universität München


More shows like Medizin - Open Access LMU - Teil 19/22

View all
Hegel lectures by Robert Brandom, LMU Munich by Robert Brandom, Axel Hutter

Hegel lectures by Robert Brandom, LMU Munich

8 Listeners

MCMP – Philosophy of Science by MCMP Team

MCMP – Philosophy of Science

1 Listeners

Sommerfeld Lecture Series (ASC) by The Arnold Sommerfeld Center for Theoretical Physics (ASC)

Sommerfeld Lecture Series (ASC)

0 Listeners

John Lennox - Hat die Wissenschaft Gott begraben? by Professor John C. Lennox, University of Oxford

John Lennox - Hat die Wissenschaft Gott begraben?

4 Listeners

Theoretical Physics Schools (ASC) by The Arnold Sommerfeld Center for Theoretical Physics (ASC)

Theoretical Physics Schools (ASC)

2 Listeners

Medizin - Open Access LMU - Teil 09/22 by Ludwig-Maximilians-Universität München

Medizin - Open Access LMU - Teil 09/22

0 Listeners

MCMP – Philosophy of Physics by MCMP Team

MCMP – Philosophy of Physics

3 Listeners

Epistemology and Philosophy of Science: Prof. Dr. Stephan Hartmann – HD by Ludwig-Maximilians-Universität München

Epistemology and Philosophy of Science: Prof. Dr. Stephan Hartmann – HD

1 Listeners

Podcast Jüdische Geschichte by Abteilung für Jüdische Geschichte und Kultur, LMU München

Podcast Jüdische Geschichte

1 Listeners

ISCB34 - 34th Annual Conference of the International Society for Clinical Biostatistics - Munich, 25-29 August 2013 by Prof. Dr. rer. nat. Ulrich Mansmann

ISCB34 - 34th Annual Conference of the International Society for Clinical Biostatistics - Munich, 25-29 August 2013

0 Listeners