Related Experiment Video
Updated: Apr 20, 2026
03:14
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
2.1K
[Epidural bleeding after labor epidural analgesia].
K Bouattour1, G Moyano-Tidou1, A Le Gouez1
1Département d'anesthésiologie, hôpital Antoine-Béclère, groupe hospitalier Paris Sud, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Annales Francaises D'Anesthesie Et De Reanimation
|December 4, 2014
Summary
Epidural bleeding is a rare complication following labor epidural analgesia, potentially causing significant nerve root injury. Prompt diagnosis is crucial for managing this serious postpartum neurological deficit.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Anesthesiology
Background:
- Epidural analgesia is commonly used for labor pain management.
- Postpartum neurological deficits can arise from various causes, including labor and anesthesia.
- Anaesthetists play a key role in managing these deficits.
Observation:
- A 34-year-old parturient experienced severe right leg motor and sensory deficits post-labor epidural analgesia.
- Neurological deficits were predominantly on L5 and S1 nerve roots, diagnosed as central nerve root injury.
- Lumbar MRI revealed non-compressive epidural bleeding anterior to the L5 vertebral body.
Findings:
- Epidural bleeding is a rare but serious complication of labor epidural analgesia.
- Distinguishing anesthesia-related nerve root lesions from labor-induced injuries can be challenging.
- Fetal head compression can mimic anesthesia-induced perimedullar radiculopathy.
Implications:
- This case highlights the importance of considering epidural bleeding in postpartum neurological deficits.
- Early identification and management of epidural bleeding are critical for functional prognosis.
- Understanding differential diagnoses is essential for appropriate patient care after labor epidural analgesia.
Keywords:
Analgésie périduraleAnti-inflammatoires non stéroïdiensDéficit neurologiqueEpidural analgesiaEpidural bleedingHéparine de bas poids moléculaireLow-molecular weight heparinLumbosacral plexusNeurological deficitNonsteroidal anti-inflammatory drugsObstetrical laborPlexus lombosacréPost-partumPostpartumSaignement périduralTravail obstétrical
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
1.0K
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
1.0K
01:22Aneurysm IV: Nursing Management
608
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
608
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
2.0K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
2.0K
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
2.1K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
2.1K
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.7K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.7K
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
1.2K
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
1.2K