• Int J Gynaecol Obstet · Oct 1999

    Case Reports

    Should laboring parturients with Harrington rods receive lumbar epidural analgesia?

    Harrington rods are not a contraindication to epidural analgesia but do increase insertion difficulty, technique failure and complications, particularly dural puncture and subdural placement.

    pearl
    • A M Ho, W D Ngan Kee, and D C Chung.
    • Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin. hoamh@hotmail.com
    • Int J Gynaecol Obstet. 1999 Oct 1;67(1):41-3.

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    Notes

    pearl
    1

    Harrington rods are not a contraindication to epidural analgesia but do increase insertion difficulty, technique failure and complications, particularly dural puncture and subdural placement.

    Daniel Jolley  Daniel Jolley
    summary
    1

    A case report and brief literature review examining the efficacy and complications of labor epidural analgesia in patients with Harrington rods after scoliosis surgery.

    Ho, Ngan Kee & Chung reviewed 52 reported cases in the literature showing:

    • Successful catheter insertion on first attempt in 47%
    • Satisfactory and uncomplicated analgesia in 55%.
    • Dural puncture in 4%.
    • Subdural catheterization in 4%.

    Lowest success rates, highest repeated-attempts and highest complication rates (DP 8%, failure 8%, poor analgesia 55%) occurred in those with a spinal surgery scar extending below the epidural insertion point.

    Daniel Jolley  Daniel Jolley
     
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