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Canadian Journal of Anesthesia 51:93 (2004)
© Canadian Anesthesiologists' Society, 2004

Correspondence

Labour analgesia in a parturient with lumbar tattoo: a routine management? or not?

Krzysztof M. Kuczkowski, MD

San Diego, California

To the Editor:

Douglas and Swenerton first reported on the administration of labour analgesia in three parturients with lumbar tattoos and discussed the possible ramifications of neuraxial analgesia in women with tattoos in the lumbar area.1 All three women received uneventful epidural analgesia, and no anesthesia-related complications were reported. I herein present a similar case, and the first report of a minor anesthesia complication resulting from epidural needle insertion through tattoos during the performance of neuraxial block. A 34-yr-old, healthy female at term was in labour and requested labour analgesia. Preanesthetic back examination revealed the colourful tattoos covering her entire lumbar area. An epidural block was performed in a standard manner (one attempt at L2–3 interspace) with an 18-gauge Tuohy needle. Several hours after an uneventful delivery, the patient reported tenderness and burning in the lumbar area where the epidural catheter had been sited. Examination revealed a localized L2–3 interspace tenderness, however, due to the presence of a tattoo in this area, skin redness (irritation) could not be determined. The neurological examination was normal and her symptoms resolved over the next 24 hr. A pigment-containing tissue core from a tattoo seems a possible cause of deeper lumbar tissue irritation.

Reference

1 Douglas MJ, Swenerton JE. Epidural anesthesia in three parturients with lumbar tattoos: a review of possible implications. Can J Anesth 2002; 49: 1057–60.[Abstract/Free Full Text]


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M. Joanne Douglas and Jean E. Swenerton
CJA 2004 51: 93. [Full Text]  



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