Obstetrical anaesthesia at Winnipeg Women's Hospital 1975-83: anaesthetic techniques and complications

The obstetrical anaesthesia experience of the Winnipeg Women's Hospital from 1975 to 1983 was reviewed (n = 22,925 infants). Use of narcotics in labour for analgesia decreased from 38.7 to 18.3 per cent of the deliveries. For analgesia during spontaneous vaginal deliveries, epidural anaesthesia increased from 6.0 to 24.0 per cent, inhalational analgesia decreased from 53.7 to 3.2 per cent while "no anaesthetic intervention" rose from 40.3 to 72.8 per cent. Use of epidural anaesthesia for Caesarean section increased from 58.7 to 82.6 per cent. The most common acute complications of anaesthesia were hypotension and inadvertent dural puncture during epidural catheterization. The incidence of hypotension decreased from 28.3 to 17.4 per cent during the nine-year period. Dural puncture decreased from 4.7 to 1.1 per cent of all epidural administrations. Postpartum complaints (that were thought to be related to anaesthesia) were mainly headache, back pain and sore throat. The incidence of these complaints also decreased over the study period.