Case Report: Pneumocephalus after labor epidural anesthesia
Beatriz Nistal-Nuño1, Manuel Ángel Gómez-Ríos1
1Department of Anaesthesiology and Perioperative Medicine, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, 15006, Spain.
F1000Research
|September 12, 2014
Summary
Minimizing air use in the loss-of-resistance (LORA) technique for epidural anesthesia and avoiding it after dural puncture can prevent pneumocephalus (PC). Using saline instead of air can also avoid PC complications during labor analgesia.
Area of Science:
- Anesthesiology
- Neurology
Background:
- Lumbar epidural anesthesia is a common method for labor analgesia.
- The loss-of-resistance to air (LORA) technique is frequently used to identify the epidural space.
- Pneumocephalus (PC) is a rare but serious complication associated with the LORA technique.
Purpose of the Study:
- To report a case of pneumocephalus (PC) following the loss-of-resistance to air (LORA) technique for labor analgesia.
- To highlight the potential risks and preventive measures associated with LORA.
Main Methods:
- Case report of a parturient who developed headaches after epidural anesthesia.
- Diagnostic imaging using computed tomography (CT) scans of the brain to confirm PC.
- Symptomatic treatment and patient follow-up.
Main Results:
- The patient experienced frontal and subsequent occipital headaches after LORA for epidural anesthesia.
- CT scans confirmed the presence of pneumocephalus (PC).
- The patient recovered with symptomatic treatment and was discharged on day 13.
Conclusions:
- Minimize the volume of air used during the LORA technique to identify the epidural space.
- Avoid using the LORA technique subsequent to dural puncture.
- Consider using saline instead of air to prevent pneumocephalus (PC) complications during epidural procedures.
