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/


Background During neuraxial access attempts, loss-of-resistance technique with air may inadvertently become injection-of-air technique potentially leading to intracranial air.

Objective The 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.

Methods After 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.

Results Only 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.

Conclusion In 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.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.


The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Wayne State University: IRB Administration Office gave ethical approval as concurrence of exemption for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.


I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).


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Data Availability

All data produced in the present work are contained in the manuscript

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