© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org
Incidence of severe complications after central neuraxial block
Melbourne, Australia
E-mail: steven.fowler@alfred.org.au
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Editor—Cook and colleagues'1 important prospective audit confirms that epidural procedures are associated with permanent harm much more frequently in the general perioperative population than in the obstetric setting and that spinal anaesthesia is relatively safe. An individualized approach to the informed consent process is emphasized in the accompanying editorial,2 where the risk discussed with a particular patient is tailored to the clinical indication instead of providing the overall headline figure.
It can be argued that the 22 patients who made a complete recovery (and the other cases with full recovery before notification) should have been included in the analysis because these complications had the potential to cause a permanent motor deficit or death. Undoubtedly, the clinicians involved (and the patients themselves) would categorize these serious complications as ‘major’ in view of the complex multidisciplinary care often required to avoid a poor outcome and,
1 Bath, UK
2 Wrexham, UK
3 Dundee, UK
* E-mail: tcook@rcoa.ac.uk
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  V. Moen, L. Irestedt, N. Dahlgren, T. M. Cook, D. Counsell, and J. A. Wildsmith Major complications of central neuraxial block: the Third National Audit Project: some comments and questions Br. J. Anaesth., July 1, 2009; 103(1): 130 - 132. [Full Text] [PDF]
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