Neurological complications in obstetric regional anaesthesia

Postnatal neurological problems are more likely to be the result of labour than regional analgesia or anaesthesia. The incidence may be as high as one in 100 deliveries, but symptoms usually resolve within a few days. Compressive neuropathy is the most likely mechanism, with femoral and lateral cutaneous nerves most commonly affected. Regional blocks can lead to postnatal neurological problems, although the incidence is difficult to establish. Studies that have attempted to determine a figure often have methodological flaws and the incidence is likely to be related to local practice. Complications of regional blocks may be traumatic, chemical, ischaemic or infective. Knowledge of the mechanism by which regional blocks cause damage and meticulous technique may help to reduce the incidence of these problems.