If certain basic precautions are taken it is a very safe anaesthetic technique. Serious complications are very rare. They are due to direct damage by the needle to the nerves or epidural cord, local infection, toxicity of the local anaesthetic and blood clot formation in the epidural space, which can compress and damage the spinal cord or local nerve roots.
Again, these complications are very rare: blood clot formation with damage to cord and nerves is thought to happen in only one of 150 000 epidural procedures, and is mostly due to a fault in the patient’s clotting system or medication that prevents clotting. There have been only about 80 reports in history of patients who were paralysed because of epidural clots, while millions of epidurals have been performed.
Reviewed by Prof CL Odendal, senior specialist at the department of anaesthesiology at the University of the Free State, April 2010.