The Epidural Book by Richard Siegenfeld

Author:Richard Siegenfeld
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2012-03-15T00:00:00+00:00

Some experts believe that fully healed tattoos with fully dry dye are not a problem. They suggest that “dye is inert and even the microscopic amount of skin that might be drawn into the body should pose no risk.” But other anesthesiologists remain unsure about accessing the epidural space through tattooed skin. Almost everyone I work with will try to avoid a tattoo and still give the woman her epidural. Two FDA studies are reportedly under way to clarify this issue.23

A much more worrisome condition is a bleeding abnormality. There are many causes of bleeding problems. Some stem from childbirth, and others occur later in life, from some disorder, disease, or medication. In chapter 9 I discussed the potentially disastrous consequences if an epidural or a spinal is placed in a woman with a bleeding abnormality caused by very strong blood thinners. The risk of a serious problem exists with a bleeding abnormality from any cause. This is why a woman with a history of easy bruising or unusually excessive bleeding, or someone who has taken medication or acquired a disease or disorder that may affect her blood’s ability to clot, will raise red flags for any anesthesiologist. Very few of the epidurals and spinals out of the millions administered actually result in nerve injuries, but when a nerve injury does occur, a preexisting bleeding abnormality is often the cause.

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