Document Detail

Extradural abscess complicating extradural anaesthesia for caesarean section.
MedLine Citation:
PMID:  1467114     Owner:  NLM     Status:  MEDLINE    
Extradural abscess has been described infrequently as a complication of extradural anaesthesia and analgesia. We describe an abscess that developed 5 days after operation in a patient who had extradural anaesthesia for Caesarean section and postoperative analgesia, and review the literature on extradural abscess complicating extradural catheterization, including a discussion on pathogenesis, clinical presentation, diagnosis and management. There have now been 16 reported cases of extradural catheter-related extradural abscess. Only one previous case has been in obstetric practice, despite the widespread use of these techniques in this specialty. A disproportionate number of cases have involved thoracic catheters. Duration of catheterization ranged from 40 h to 6 weeks, the majority of catheters being in place for 5 days or less. The time from catheter placement to development of symptoms ranged from 72 h to 5 months. The causative organism was isolated in 11 cases: Staphylococcus aureus was identified in nine (82%) and Staphylococcus epidermidis in two (18%). Outcome was reported in 15 cases, of which seven (47%) had a full or near full recovery and eight (53%) had a persistent neurological deficit. One case was managed successfully without surgery. Fifty percent of all cases have been reported in the past 5 years. With the increasing use of extradural techniques for anaesthesia and analgesia, this serious complication may be seen more frequently in the future.
W D Ngan Kee; M R Jones; P Thomas; R J Worth
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  69     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-28     Completed Date:  1993-01-28     Revised Date:  2007-04-27    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  647-52     Citation Subset:  IM    
Department of Surgery, Wellington School of Medicine, New Zealand.
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MeSH Terms
Abscess / etiology*
Anesthesia, Epidural / adverse effects*
Anesthesia, Obstetrical / adverse effects*
Cesarean Section*
Epidural Space
Postoperative Complications*
Staphylococcal Infections*
Comment In:
Br J Anaesth. 1993 Jun;70(6):703-4   [PMID:  8329274 ]
Br J Anaesth. 1993 Jun;70(6):703; author reply 704   [PMID:  8329273 ]

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