Spinal-Epidural Complications

Spinal-Epidural Complications - Complications and Side...

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Complications and Side Effects of Obstetric Neuraxial Anesthesia and Analgesia Dmitry Portnoy, MD Anesthesiology Department
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Multiple Classifications Life-threatening and non-life-threatening Common and unusual Short term and long term Primary system affected (e.g., neuro, respiratory, CV etc.) Maternal and fetal By the agent used By timing Procedural/Preoperative/Pre- labor analgesia Intraoperative/Intrapartum/Immediate Postoperative/Postpartum/Delayed
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Procedural/Preoperative/Pre-analgesia Inability to reach subarahcnoid space (anatomy, position) CSF present, but no block (technical, drug, LA resistance) Inability to locate epidural space Inability to thread the catheter Intravascular insertion of the catheter Unintended dural puncture Needle/ catheter damage – foreign body formation
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Intraoperative/Intrapartum/Immediate Cardio-vascular complications Hypotension Cardiac arrhythmias Cardiac arrest Respiratory problems Perceived Secondary motor blockade Unexpectedly high block High block Total spinal block
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Intraoperative/Intrapartum/Immediate Impaired thermoregulation Shivering Maternal hyperthermia Local anesthetic toxicity Intravascular injection Secondary to large volume Nausea and vomiting Pruritus Anxiety, panic attack
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Postoperative/Postpartum/Delayed PPDH Urinary retention Neurological complications Infectious complications Back pain Unusual (“zebra”) complications Horner’s syndrome Hearing loss Swallowing difficulties
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This note was uploaded on 12/28/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Spinal-Epidural Complications - Complications and Side...

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