Crawford J S
Anaesthesia. 1985 Dec;40(12):1219-25. doi: 10.1111/j.1365-2044.1985.tb10664.x.
A review of the maternal complications encountered in a consecutive series of over 27 000 lumbar epidural blocks (exclusive of epidurals administered for elective Caesarean section and complications of a relatively minor or fleeting nature) in a single obstetric unit is presented. There were nine potentially life threatening complications, of which only three caused real concern for the mother's safety. Six of these occurred with the first top-up, as given by the anaesthetist. The others were the result of three out of the approximately 100 000 top-ups administered by midwives. There were two serious, but not life-threatening complications, each of which led to the requirement of a laminectomy. In addition, there were 13 moderately serious and 17 mildly disturbing complications. All the mothers concerned made a full recovery. There was a large number of inconsequential or pseudocomplications which, although initially blamed upon the epidural, were later demonstrated to have been of a different origin. Consideration of this experience leads to the conclusion that if the rules of management are rigorously followed, epidural analgesia for labour and delivery, including topping-up by well-informed midwives, is characterised by an extremely high level of safety for the mother.
本文回顾了在单一产科单位连续进行的超过27000例腰段硬膜外阻滞（不包括择期剖宫产硬膜外阻滞及相对轻微或短暂性并发症）中遇到的母体并发症情况。有9例潜在的危及生命的并发症，其中只有3例真正引起了对母亲安全的担忧。其中6例发生在麻醉师首次追加用药时。其他并发症是在助产士进行的约100000次追加用药中有3次导致的。有2例严重但不危及生命的并发症，每例均需进行椎板切除术。此外，还有13例中度严重和17例轻度困扰的并发症。所有相关母亲均完全康复。有大量无关紧要或假性并发症，尽管最初归咎于硬膜外阻滞，但后来证明其起源不同。对这一经验的思考得出结论：如果严格遵循管理规则，分娩时的硬膜外镇痛，包括由知识渊博的助产士进行追加用药，对母亲来说具有极高的安全性。
