WSJ Examines Safety Of Administering Epidurals Through Lower-Back Tattoos

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

A 2002 study published in the Canadian Journal of Anesthesiaquestioned whether complications such as inflammation or nerve damagemight occur if the epidural needle pulled some of the dyed skin alongwith it and then deposited it into the region outside the spinalcolumn. The study of three women -- conducted by Joanne Douglas andcolleagues from the British Columbia Women's Hospital -- found noconclusive evidence that the procedure was unsafe, but it "set off amini-wave of panic" among pregnant women, according to the Journal.

Douglasrecommended that anesthesiologists avoid the tattoo when administeringan epidural or create a nick in the skin before injecting the needle,which could minimize the likelihood of skin being pulled down with theinjection. Douglas also said that physicians should tell women thatwhile there is no proof that complications will occur whenadministering an epidural through a tattoo, there remains a potentialrisk.

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

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