Wall Street Journal Examines Concerns About Safety Of Administering Epidurals Through Lower-Back Tattoos

Main Category: Pain / Anesthetics
Also Included In: Pregnancy / Obstetrics;  Dermatology;  Women's Health / Gynecology
Article Date: 21 Sep 2007 - 10:00 PDT

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The Wall Street Journal on Tuesday examined concerns that administering an epidural through a tattoo might pose health risks to the pregnant woman. According to the Journal, there has been an increase in recent years in women's lower-back tattoos, which often cover the surface near the vertebrae where the epidural needles are inserted. The Journal of the American Academy of Dermatology in 2006 reported that nearly 25% of U.S. residents ages 18 to 50 are tattooed, and 20% of tattooed women in the age group have lower-back tattoos. Epidurals are used in almost 65% of the four million births reported in the U.S. annually, the Journal reports.

A 2002 study published in the Canadian Journal of Anesthesia questioned whether complications such as inflammation or nerve damage might occur if the epidural needle pulled some of the dyed skin along with it and then deposited it into the region outside the spinal column. The study of three women -- conducted by Joanne Douglas and colleagues from the British Columbia Women's Hospital -- found no conclusive evidence that the procedure was unsafe, but it "set off a mini-wave of panic" among pregnant women, according to the Journal.

Douglas recommended that anesthesiologists avoid the tattoo when administering an epidural or create a nick in the skin before injecting the needle, which could minimize the likelihood of skin being pulled down with the injection. Douglas also said that physicians should tell women that while there is no proof that complications will occur when administering an epidural through a tattoo, there remains a potential risk.

William Camann, chief of obstetric anesthesia at Brigham and Women's Hospital, said women with lower-back tattoos should not be concerned about the epidural as long as the ink has dried fully and the wound is healed. He said at that point the dye is set and even the microscopic amount of skin that might be drawn into the body should pose no risk. FDA said tattoo inks and pigments are regulated by the agency, but due to other health priorities, the agency has not approved any specific inks. Two FDA-sponsored studies are ongoing to assess possible adverse side effects to the ink and methods to test it for toxicity, the Journal reports (Zimmerman, Wall Street Journal, 9/18).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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