Epidural anaesthesia and risk evidence table

The table below contains the evidence we have used in our risk information for epidural anaesthesia.

Category	Risk	Reference
Needed additional pain relief as well as the epidural	10 in 100	Combined spinal‐epidural versus epidural analgesia in labour Epidural versus non‐epidural or no analgesia for pain management in labour Effect of combined spinal–epidural analgesia versus epidural analgesia on labor and delivery duration ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia Risk factors and peripartum outcomes of failed epidural: a prospective cohort study
Had to have the epidural resited	5 in 100	Combined spinal‐epidural versus epidural analgesia in labour Epidural versus non‐epidural or no analgesia for pain management in labour Effect of combined spinal–epidural analgesia versus epidural analgesia on labor and delivery duration
Headache (post-dural puncture headache)	0.01	Accidental dural puncture and post dural puncture headache in obstetric anaesthesia: presentation and management: a 23-year survey in a district general hospital
Had a fever	0.11	Cohort study: Labor epidural analgesia and intrapartum maternal hyperthermia
Had low blood pressure	0.03	Systematic review: Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review
Felt sick	0.09	Systematic review: Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review
Had itching	0.33	Systematic review: Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review
Difficulty passing urine	20–50%	Literature review: Side effects of intrathecal and epidural opioids
Local anaesthetic toxicity	0.04–0.18%	Narrative review: Updates in our understanding of local anaesthetic systemic toxicity
Weak, numb, tingly leg, buttock or foot (temporary)	1 in 2,674	Literature review: Neurological complications in obstetric regional anaesthesia
Weak, numb, tingly leg, buttock or foot (permanent)	1 in 15,000	Third National Audit Project (NAP3): Major complications of central neuraxial block in the UK
Infection in or around the spine	1 in 145,000	Third National Audit Project (NAP3): Major complications of central neuraxial block in the UK
Meningitis	1 in 50,000	Third National Audit Project (NAP3): Major complications of central neuraxial block in the UK
Blood clot in or around the spine	1 in 168,000	Third National Audit Project (NAP3): Major complications of central neuraxial block in the UK
Effectiveness of blood patch		Short report: Broom MA. Accidental dural puncture during epidural blood patch: a narrative review. IJOA 2023;55:103900