Neurologic deficits and labor analgesia

Permanent neurologic injury associated with labor and delivery is fortunately very rare. Transient neurologic injury is not rare, and because of the temporal association to neuraxial anesthesia, anesthesiologists are frequently called on to evaluate postpartum nerve injury. Injuries may occur spontaneously; they may be intrinsic to labor and delivery or result from obstetric or anesthetic interventions. Most postpartum nerve injury is not directly related to neuraxial analgesia. However, injury secondary to anesthesia does occur, and serious, limb-threatening injuries need to be ruled out. Strict attention to technique may further limit the rare injury directly related to anesthesia. Even self-limiting neuropathies may be debilitating, especially injuries with a motor component.