Lumbar tattoos and epidural anesthesia in childbirth

It is not uncommon to find that more and more women with a tattoo in the lower back, the fashion for drawing on the skin is a widespread practice; just as it is in the world of obstetrics, the administration of epidural anesthesia for those women in childbirth who request it. A few years ago a great

It is not uncommon to find that more and more women with a tattoo in the lower back, the fashion for drawing on the skin is a widespread practice; just as it is in the world of obstetrics, the administration of epidural anesthesia for those women in childbirth who request it.

A few years ago a great controversy was created about whether it was possible or not to opt for an epidural analgesia if you had a tattoo on the lower back. Even today, in childbirth classes, it is a question that is not missing: If I have a tattoo on my lower back, can I have an epidural?

Epidural and tattoos: is it incompatible?

It is true that there was a time when some anesthetists refused to puncture the back of those women who carried a tattoo, to administer the epidural. This was due to the theoretical possibility that if pigment was introduced into the peridural spaces, the short and long term acute complications could be serious (inflammatory neuropathy, infections or even epidermoid tumors).

Pregnant women should know that the group of anesthetists generally includes in their protocols of clinical practice, the tattoo on the lower lumbar area as a relative contraindication for the administration of epidural anesthesia.

But what does the scientific evidence tell us? To date, none of the announced hypothetical complications has been produced, even in the case that the needle with which the puncture is made has pierced the tattoo (the pigments used for this type of body art can be sterilized) . For this reason several anesthetists and dermatologists have changed their attitude pasando, going from an initial alarm to a later acceptance to perform the technique.In addition we have to take into account that the epidural needle has a minimum thickness of about 2mm and the vast majority of tattoos do not cover the entire area and leave

skin gaps that can be punctured . Even sometimes the puncture can be located a little more laterally or at different levels of the lumbar spine so as not to interfere with the tattooed area.In conclusion we could say that the possible risks of the epidural in the presence of tattoos in lumbar areas have been overestimated, since there has not yet been any complication associated with the epidural tattoo. However, we recommend women who are carriers of the same, to speak with the anesthetist before the delivery to find out what is the position of the professionals in this regard; and avoid surprises if the big day decide to opt for an epidural analgesia.