High Neuraxial Block in Obstetrics: A 2.5-Year Nationwide Surveillance Approach in the Netherlands
Authors' conclusion
High neuraxial block requiring tracheal intubation is a rare but impactful complication in obstetric anesthesia, potentially affecting both mother and fetus. Spinal anesthesia after epidural analgesia in labor is a common cause of high neuraxial block.
Study context
- Population
- Obstetric patients receiving neuraxial procedures in all Dutch hospitals with a maternity unit (Netherlands Obstetric Surveillance System (NethOSS)), Nov 2019–May 2022cases identified
- Participants
- 5 patients
- Outcome
- Incidence of high neuraxial block requiring ventilatory support or CPR
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Incidence of high neuraxial block requiring tracheal intubation
Estimated incidence per neuraxial procedures in labor
1 in 29,770
95% CI 1:12,758–1:91,659
Observational data: associations, not effects.
Further findings
Clinical features of cases
- Cases after single-shot spinal anesthesia for Cesarean delivery after epidural analgesia in labor
- 3 of 5
- Case in labor ward due to inadvertent intrathecal or subdural labor catheter
- 1
- Case after single-shot spinal for elective Cesarean delivery
- 1
Safety
Maternal and neonatal outcomes
- Successfully extubated in OR after Cesarean delivery, no ICU admission
- 5
- Cardiac arrests
- 0
- Neonatal deaths
- 0
Original publication
High Neuraxial Block in Obstetrics: A 2.5-Year Nationwide Surveillance Approach in the Netherlands. Anesth Analg. Published 31 January 2024. doi:10.
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