Complications Associated With Epidural Anesthesia in Obstetric Patients: A Clinical-Statistical Analysis

Epidural anesthesia (EA) remains the gold standard for labor analgesia worldwide. While its efficacy in pain management is well established, neurological complications present critical challenges for both obstetricians and neurologists. This study evaluates the incidence, clinical spectrum, and underlying risk factors of neurological complications associated with EA in a cohort of 1,240 obstetric patients. Prospective clinical monitoring and neuroimaging were used to assess postpartum neurological deficits. The overall incidence of neurological complications was 0.89% (11 cases). Transient postpartum nerve palsies, predominantly involving the peroneal nerve, were the most prevalent mechanical complications (0.48%), followed by post-dural puncture headache (PDPH) requiring epidural blood patch intervention (0.32%). Severe structural injuries, such as spinal epidural hematoma or abscess, occurred in 0.08% of cases. Statistical analysis confirmed that multiple insertion attempts (>3) and maternal body mass index (BMI >35 kg/m²) were significantly associated with an increased risk of neurological sequelae (p < 0.05). Early multidisciplinary diagnosis, including prompt neurological assessment, ensures favorable outcomes and helps prevent permanent motor or sensory deficits.