The risk of vertebral canal complications in 2837 cardiac surgery patients with thoracic epidurals*

Abstract

Retrospective analysis of our working practice indicates that thoracic epidural anaesthesia and analgesia are safe in patients receiving cardiac surgery. We found no epidural haematoma or abscess in 2837 patients.

Nationwide incidence of serious complications of epidural analgesia in the United States

“…This finding is in agreement with the low incidence of this complication reported in the literature 18,43,44 . We were unable to identify any cases of spinal hematoma in patients undergoing open cardiac surgery.…”

“…7,8 Unfortunately, published data on the incidence of spinal hematoma and abscess are conflicting. [15][16][17][18] Although some large prospective and retrospective studies have attempted to describe the incidence of these severe complications, they do not always provide an accurate description of the population studied or provide the denominator used to calculate the incidence. In obstetric patients the complication rates are lower, with incidences reported in the range of 1:205,000-1:288,000 12,13 and 1:62,000-1:205,000 12,14 for spinal hematoma and epidural abscess, respectively.…”

Spinal At T10 (10th Thoracic)

“…Unintentional dural perforation was observed more often during lower thoracic epidural procedure, but no epidural hematomas or abscesses were identified. 23,24,25 The absence of neurological sequelae caused by thoracic epidural procedure is supported by other studies. 13,14 …”

Incidence of spinal haematoma after epidural puncture

“…[1][2][3][4]6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Case reports of spinal haematoma after epidural analgesia are rare. 28 In fact, there is no report in conjunction with anticoagulation in the obstetric population.…”