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Evidence Library · Pain relief

The headache, and the rare serious complications

Real numbers, so you can size them properly.

Occasionally the epidural needle punctures the sac holding spinal fluid. In pooled obstetric data this happens in about 1.5% of placements, and when it does, about 52% of those women develop a headache that is much worse sitting up. It can be treated with a blood patch.

The serious complications, across 1.37 million obstetric epidurals:

ComplicationRate
Epidural hematoma1 in 168,000
Deep epidural infection1 in 145,000
Permanent nerve injury1 in 240,000
Temporary nerve injury1 in 6,700

Permanent harm is roughly a one in a quarter million event. A patch of numb thigh that resolves is far more common.

Where this comes from:
192. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Can J Anaesth. 2003;50(5):460-469.
193. Ruppen W, Derry S, McQuay H, Moore RA. Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesia/anesthesia. Anesthesiology. 2006;105(2):394-399.

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