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 of neurological problems may be as high as 1 in 100 deliveries, but symptoms usually resolve within a few days following birth. Compressive neuropathy is the most likely cause of these problems, 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 the incidence often have methodological flaws, and also the incidence is likely to be related to local practice. Complications of regional blocks may be traumatic, chemical, ischaemic or infective in nature. Knowledge of the mechanism by which regional blocks cause damage, and maintaining a meticulous technique may help reduce the incidence of these problems.