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The largest ever prospective study into the major complications of epidurals and spinal anaesthetics found that the estimated risk of permanent harm following these anaesthetics is lower than 1 in 20,000 while the risk of being paralysed by one of these injections is 2-3 times rarer than of suffering any permanent harm.

The risk for women requiring pain relief for labour or Caesarean section is lower still, the most pessimistic estimate of permanent harm is 1 in 80,000 and it may be much lower. A similarly low risk was found in procedures performed for chronic pain and in children.

The risk of harm when an epidural is used for surgery is considerably higher than the estimated risk of using it during childbirth: between 1 in 6,000 and 1 in 12,000. However, these figures are still considerably lower than previously thought. It has been long known that these complications occur more often after surgery. The reason is likely to be due to the fact that many of these patients are elderly with medical problems and that the process of having surgery itself increased the risk.
Major surgeries lead to severe pain and may mean that an epidural has to stay in place for several days. Epidurals are generally only used for the biggest most painful operations and it is probably the least fit patients who have the most to gain from these techniques.

The project has shown is that many epidurals’ complications occur after major surgery in elderly unhealthy patients.


The project's results are based on the voluntary participation of every hospital in England, Scotland, Wales and Northern Ireland. All the complications of the epidurals have been reviewed by an expert panel, which assessed the cause and severity of all permanent injuries.

During the study that lasted for one year, there were 14-30 patients who suffered permanent injuries ranging from numbness in a part of the legs to paraplegia or death. Of the harmed patients 5-13 were paralyzed and 3-6 died. Most complications were judged to be unavoidable.

Although the study found that the complications related to epidurals were rare, the researchers believe that the it still needs to be examined how and why these complications occur as well as make steps to reduce their frequency.

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This is comforting news for women who need pain relief for labor or C-section.
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