RISKS AND COMPLICATIONS OF EPIDURAL-ANEST HESIA

Postoperative neurological sequelae in patients that have received epi dural anaesthesia are not necessarily caused by the epidural anaesthet ic technique. As a whale, adverse neurological outcomes following epid ural anaesthesia may be subdivided into 3 different ethiological categ ories. A first category involves events that are not at all caused by the epidural, but merely due to the interference of anaesthesia and/or surgery with a preexisting medical condition. A second category inclu des mishaps such as backache, arachnoiditis, and post-dural puncture h eadache that are solely due to the epidural anaesthesia. Finally epidu ral anaesthesia may be a contributory factor in the development of pos t-anaesthetic complications attributable to a pre-existing medical con dition that are triggered by anaesthesia, surgery or childbirth. These complications include some of the most dramatic sequelae of major neu raxial blockade, such as spinal epidural abscess, spinal infarction,an d spinal hematoma. Although extremely rare, the latter complications o ften result in permanent major neurological deficits. The present manu script is a review of the most recent, literature addressing post-anae sthetic sequelae,and will discuss their incidence, pathophysiology, cl inical course, diagnosis, prevention, and treatment.