An Analysis of Infection-Related Complications after Epidural Block / 대한통증학회지

ABSTRACT

BACKGROUND: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. METHODS: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. RESULTS: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. CONCLUSIONS: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.