Abstract -- From Henci Goer's book "Obstetric Myths Versus Research Realities"
MacArthur, C., Lewis M., and Knox E.G. Investigation of long term problems after obstetric epidural anaesthesia. BMJ 1992; 304: 1279-1282.
Data on long term postpartum effects (meaning began at 3 months or less after birth, lasted 6 or more weeks, never experienced prior to birth) of epidurals were gathered from hospital case notes and postal questionnaires mailed to mothers. Data ranged from 13 months to 9 years postpartum. No information on severity was obtained. The 11,701 women represented 78 percent or more of those mailed questionnaires. Of them, 4,766 had epidurals and 6,935 did not. Discriminant analysis was used because it eliminates associations with epidurals that might arise because epidurals associate with more interventive deliveries. [But since epidurals cause operative delivery, they could be an indirect cause of problems in such cases.-HG]
Symptoms that were more likely to be reported after epidural were backache (18.2 percent versus 10.2 precent p<0.001), neckache (2.4 percent versus 1.6 percent, p<0.01), tingling in the hands (3.0 percent versus 2.2 percent, p<0.01), dizziness or fainting (2.1 percent versus 1.6 percent, p<0.05), and visual disturbances (1.7 percent versus 1.3 percent [no p value given]). Spinal headache occurred in 34 women as a result of accidental dural puncture (0.1 percent of all epidurals) or spinal anesthesia (2.5 percent of all spinal blocks). Although this headache is believed to subside within a week even without treatment, nine women reported the headache lasted more than 6 weeks and five that it lasted more than 1 year. Headache, neckache and tingling related to epidural only when reported in association with backache. Visual disturbances related only to migraine. In response to an open-ended question, 26 women reported numbness or tingling in lower back, buttocks, or leg, of whom 23 had an epidural--a "highly significant" difference. Most symptoms had lasted much longer than the six weeks of the study definition. "About two thirds were still present at the time of our inquiry. It was clear that many problems had become chronic."
-Henci Goer, "Obstetric Myths Versus Research Realties," Bergin & Garvey, Westport CT, 1995
Reprinted from Midwifery Today E-News (Vol 1 Issue 9, Feb. 26, 1999)
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