Case report of Sensory Changes Following Labor Epidural Analgesia Sara Gier, BS,a Jose L Diz Ferre, MD,b Sabry Ayad, MD MBAb aOhio University Heritage College of Osteopathic MedicinebCleveland Clinic Foundation, Outcomes Research, Anesthesiology Department, Cleveland, Ohio Corresponding Author Sabry Ayad, MD, MBA Department of Anesthesiology 18101 Lorain Ave, Cleveland, OH 44111 Phone: 216 476-7052 Email: saayad@ccf.org Abstract Epidural analgesia represents a pivotal advancement in the management of labor pain, offering significant benefits in terms of pain relief and patient satisfaction. While its safety and efficacy are well-documented, practitioners must remain cognizant of the potential for rare neurological complications. These complications can range from mild sensory disturbances to severe adverse events necessitating immediate intervention. The occurrence of transient paresthesia, although infrequent, points out the potential neurological impacts associated with the epidural procedures. We present the case of a 31-year-old female, who requested epidural analgesia for labor and inadvertently developed this complication.Key clinical message Understanding neurological adverse events is central not only for diagnosing and anticipating complications but also for informing patients accurately about the risks and benefits of epidural analgesia.Keywords: anesthesia, obstetrics/gynecologyConsent statement: Written informed consent was obtained from the patient.IntroductionEpidural analgesia is a cornerstone in labor pain management, offering targeted pain relief that greatly enhances patient satisfaction and the overall childbirth experience. While its safety and efficacy are well-documented, the potential for rare but serious neurological complications requires careful consideration. Instances of transient or persistent paresthesia, though infrequent, underscore the necessity for a thorough understanding of the neurological impacts associated with epidural procedures.Neurological adverse effects, occurring at rates between 0.03 to 0.1%, can stem from various factors, such as direct needle trauma, ischemic events, or inadvertent administration of neurotoxic agents1. Other complications are unintended intravascular or intrathecal injections of local anesthetics, local anesthetic systemic toxicity, total spinal anesthesia, and high spinal block. This case report examines the occurrence of transient bilateral lower facial and oral sensory changes during labor epidural analgesia, underlining the importance of vigilant monitoring to ensure patient safety.
