January 13, 2009

Epidurals safer than previously thought

Previous studies have overestimated the risks of severe complications of epidurals and spinal anesthetics, British researchers said.

The study, published in the British Journal of Anesthesia, concluded that the estimated risk of permanent harm following a spinal anesthetic or epidural is lower than 1 in 20,000 and in many circumstances the estimated risk is considerably lower.

The study found that the odds of being badly injured by an epidural or spinal anesthetic are considerably better than 20,000-to-1 against. The risk of being paralyzed by one of these injections is 2-3 times rarer than of suffering any permanent harm.

The risk for women requiring pain relief for labor or Caesarean section is lower still; the most pessimistic estimate of permanent harm is 1 in 80,000 and it may be much lower, the researchers said.

It has been known for a long time that these complications occur more often after surgery. The reason is likely to be that many of these patients are elderly with medical problems and that the process of having surgery itself increases risks, study leader Dr. Tim Cook of the Royal United Hospital in Bath, England, said in a statement.

Many complications of epidurals occur after major surgery in elderly unhealthy patients. The risks must also be balanced against the generally accepted benefits of epidurals.