Complications of regional anesthesia in obstetrics.

Over 100 years ago August Bier performed the first recorded spinal anaesthetic; and complications from the use of regional anaesthesia have been described over this same period of time. Bier also being the first to describe a ‘spinal’ or ‘post dural-puncture headache’ [1]. In Great Britain a number of high profile legal cases in the 1950s concerning major complications of neuraxial techniques led to its decline for more than two decades [2]. However, over the last thirty years the Confidential Enquiry into Maternal Deaths has been responsible for the increased use of regional anaesthesia for caesarean section due to its increased safety [3]. This has been accompanied by a very significant decrease in the death rate attributable to anaesthesia. General anaesthesia is now used in less than 5% of caesarean sections. However, there are still a number of important complications that are associated with regional anaesthesia and analgesia.