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Neurologic Complication of Labor Analgesia: Facts and Fiction

Kuczkowski, Krzysztof M. MD

Obstetrical & Gynecological Survey: January 2004 - Volume 59 - Issue 1 - pp 47-51
CME Program: CME Review Article 1

Regional anesthesia has become a hallmark of modern obstetric anesthesia practice and a paramount technique for labor analgesia. Neurologic complications associated with present-day labor analgesia are thought to be unusual; however, they can occasionally complicate peripartum obstetric and anesthetic management of pregnant patients. To date, no review article in obstetric literature has specifically addressed the issue of possible neurologic anesthetic complications attributed to labor analgesia. Therefore, a series of systemic literature searches (Medline) to identify the articles on neurologic complication of labor analgesia was conducted. This review article summarizes the evidence from published articles on this topic, with particular emphasis on the mechanism of neurologic injury, lidocaine-related transient neurologic symptoms, anticoagulation and vascular compromise, diagnostic evaluation, and prevention of neurologic obstetric anesthesia-related neurologic injury in pregnancy.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to list the mechanisms of neurologic injuries associated with obstetric analgesia, to outline potential factors that are associated with neurologic injury, and to describe the usual evaluation of a patient with a suspected neurologic injury.

Assistant Clinical Professor of Anesthesiology and Reproductive Medicine, Director of Obstetric Anesthesia, Departments of Anesthesiology and Reproductive Medicine, University of California San Diego, San Diego, California

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 2004. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Address correspondence to: Krzysztof M. Kuczkowski, MD, Department of Anesthesiology, UCSD Medical Center, 200 W. Arbor Drive, San Diego, CA 92103-8770. E-mail:

The author has disclosed no significant financial or other relationship with any commercial entity.

© 2004 Lippincott Williams & Wilkins, Inc.