Risk Ratio (Relative Risk) And Odds Ratio For Radiologically Visible Intracranial Air After Neuraxial Access Attempts Among Our Peri-Partum Patients Were Undefined Although One In Forty Of Them Had Radiologically Visible Intracranial Air On CT/MR Of Head/Brain

Abstract

AbstractBackgroundDuring neuraxial access attempts, loss-of-resistance technique with air may inadvertently become injection-of-air technique potentially leading to intracranial air.ObjectiveThe purpose of this retrospective study was to ascertain the incidence of radiologically visible intracranial air among peri-partum patients admitted to local Women’s Hospital who underwent computed tomography/magnetic resonance imaging (CT/MR) of head/brain during their hospital stay at peri-partum floors over a seven-year period of July 1, 2015-June 30, 2022.MethodsAfter Institutional Review Board approval for exempt research, medical records of patients who underwent CT/MR of head/brain during their hospital stay at peri-partum floors over a seven-year period of July 1, 2015-June 30, 2022 were reviewed to see whether they had neuraxial access attempts (epidurals, spinals, combined spinal-epidurals, epidural blood patches) before their CT/MR of head/brain. Subsequently, such patients CT/MR of head/brain were reviewed to ascertain the evidence of any radiologically visible intracranial air.ResultsOnly 69 peri-partum patients underwent CT/MR of head/brain during the seven-year period with 40 of them receiving neuraxial access attempts before their CT/MR of head/brain. Only one labor epidural analgesia patient had radiologically visible intracranial air.ConclusionIn seven-year period sample among our peri-partum patients at local Women’s Hospital, risk ratio (relative risk) and odds ratio for radiologically visible intracranial air after neuraxial access attempts were undefined although one in forty had radiologically visible intracranial air on CT/MR of head/brain after neuraxial access attempts and that intracranial air was 100% attributable to neuraxial access attempts.