Neurologic complication of labor analgesia: facts and fiction

Abstract

Regional anesthesia has become a hallmark of modern obstetric anesthesia practice and a paramount technique for labor analgesia. Neurologic complications associated with present-day labor analgesia are thought to be unusual; however, they can occasionally complicate peripartum obstetric and anesthetic management of pregnant patients. To date, no review article in obstetric literature has specifically addressed the issue of possible neurologic anesthetic complications attributed to labor analgesia. Therefore, a series of systemic literature searches (Medline) to identify the articles on neurologic complication of labor analgesia was conducted. This review article summarizes the evidence from published articles on this topic, with particular emphasis on the mechanism of neurologic injury, lidocaine-related transient neurologic symptoms, anticoagulation and vascular compromise, diagnostic evaluation, and prevention of neurologic obstetric anesthesia-related neurologic injury in pregnancy.