Neurological complications in obstetric regional anaesthesia

Abstract

Central neuraxial blocks represent the most executed procedures in the field of obstetric anaesthesia. Most neurological complications observed in the post-partum period arise from obstetric palsies associated with the natural process of labour. It is crucial for anaesthetists to adopt a systematic methodology when evaluating neurological injuries to differentiate between causes related to anaesthesia and those that are not. Additionally, it is vital to promptly recognize circumstances that necessitate urgent investigation and intervention to avert lasting damage. Anaesthetists should possess a thorough understanding of the principles of safe practice while conducting a neuraxial block. This encompasses implementing recommended precautions to reduce the likelihood of neurological complications, such as assessing coagulation status, following infection control protocols, ensuring proper positioning and technique, maintaining effective communication with the patient throughout the procedure, and monitoring the resolution of the neuraxial block using regional anaesthesia bracelets. Moreover, anaesthetists must engage in a multidisciplinary approach to minimize risks by consulting with obstetricians, haematologists, and neurologists, as well as ensuring appropriate follow-up care and management for patients who are affected.