Major Complications of Central Neuraxial Block: Report on the Third National Audit Project of the Royal College of Anaesthetists

摘要

Limited information on the incidence and impact of serious complications of central neuraxial block (CNB) hampers clinical decision making and a truly informed consent by patients. The Royal College of Anaesthetists' Third National Audit Project was created to improve this situation. A 2-week national census estimated the number of CNB procedures performed annually in the United Kingdom (UK) National Health Service by taking this number and multiplying by 25 to establish a denominator. All major complications (vertebral canal abscess or hematoma, meningitis, nerve injury, spinal cord ischemia, fatal cardiovascular collapse, and wrong route errors) of CNBs were recorded (the numerator). Each case was assessed by an expert panel to determine causation, severity, and outcome. Permanent injury was defined as symptoms lasting more than 6 months. Efforts were made to validate denominator and numerator data through national databases.