paralyzing epidural

I had a patient in clinicals my second semester who was paralyzed from an epidural. I don't know why it happened...if it was poor technique, something about her anatomy, or what.

Also in Missouri, when I was pregnant they required women who wanted the option of having an epidural to take a class about the procedure and the risks. Paralysis was mentioned as a risk.

The risk of paralysis is approximately 1in 150,000, see link below

http://www.reddinganesthesia.com/spi...%20anesthesia?

Have looked after patients who were paralyzed from epidurals. I believe the theory behind the paralysis in the patients I saw was; the epidural caused the b/p to drop really low, which lead to an inadequate blood supply to the spinal cord, caused spinal cord ischemia and permanent parlysis.

Paralysis from epidural is very very very very very rare. You're more likely to die from general anesthesia than become paralyzed from a epidural.

I have never seen or heard of it among any hospitals I have worked at and in some the epidural rate was about 70% for first time mothers. Epidurals are safer than childbirth.

I know of two people who could not breath following epidural initiation. Apparently the vertebrae level between pain relief and paralyzing the diaphragm is fairly short, and especially in short women the meds can migrate the distance in rare cases. Always watch your mom like a hawk during the initial dosing and subsequent boluses.

Just a thought- I have never heard breathing paralysis mentioned in the risks when consent is obtained. I imagine people would like to know. Having a class before getting anepidural sounds great but unrealistic.

We discuss breathing paralysis when discussing the levels of numbness and "patchy" blocks. Generally I haven't had a problem with that as long as my patients are not laying flat.

I had that problem both times I was given a spinal for a cesarean---I couldn't feel myself breathing and absolutely freaked out! The numbness went all the way up to my throat, and even though my sats stayed in the upper 90s throughout the surgery (according to the doctors and nurses), I felt like I was suffocating.

I also had some kind of neurological damage from my first spinal (they didn't even have epidurals back then, at least not in my neck of the woods). To this day, when I get really cold and/or tired, I'll have spasms that start down in my lower back and work their way up to the base of my skull, and then comes the jerking movements that last anywhere from a few seconds to a minute or more. I've tried everything I know to try to relax during these episodes, but on a scale of 0-10 the pain rates about a 9 and all I can do is wait it out.

I never have found out exactly what went wrong with the spinal or why I'm still having these episodes occasionally 18 years later, but needless to say, I don't trust ANYTHING that has to be injected anywhere near my spinal column, and while I don't tell my patients about my experiences, I cannot recommend it to anyone!

true paralysis (paralysis of the diaphragm) is very unlikely. medullary ischemia from hypotension is thought to be the real culprit of respiratory depression and arrest after epidural placement. I might add that this is quite rare as well. The moral of the story is, IV fluid and ephedrine can be very important with epidural and spinal anesthesia. more importantly for the latter.

I would think the moral of the story is TRULY informed consent and indepth prenatal education including relaxation techniques.