An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section

Sng, Ban Leong; Lim, Y. W.; Sia, Alex

doi:10.1016/j.ijoa.2009.01.010

Cited by 47 publications

(44 citation statements)

References 27 publications

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“…However, the mean surgical time in these studies was shorter (57-67 minutes) than that observed in our study, which was conducted at a university hospital and therefore extended beyond 70 minutes (71-80 minutes) 2,6,8,19,26 .…”

Section: Discussioncontrasting

confidence: 61%

“…In this study, we used morphine (100 µg), a dose often recommended for subarachnoid space application in cesarean section, combined with hyperbaric bupivacaine with or without other adjuvants. At this dosage, the incidence of late adverse effects is lower and does not affect the quality of postoperative analgesia 6,[19][20][21][22][23][24][25] . Due to morphine side effects and slow onset of action, liposoluble opioids (fentanyl and sufentanil) are used intrathecally in combination with local anesthetics for cesarean section.…”

Section: Discussionmentioning

confidence: 95%

“…In the cesarean section, the recommended dose of morphine to provide intra-and post-operative satisfactory analgesia is 100-200 µg, while the recommended dose of sufentanil and clonidine ranges from 5 to 7.5 µg and 15 to150 mg, respectively 2,3,[6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

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Raquianestesia em operação cesariana. Emprego da associação de bupivacaína hiperbárica (10 mg) a diferentes adjuvantes

Braga¹,

Frias²,

Braga³

et al. 2012

Rev. Bras. Anestesiol.

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Summary: Braga AA, Frias JAF, Braga FS, Potério GB, Hirata ES, Torres NA -Spinal Anesthesia for Cesarean Section. Use of Hyperbaric Bupivacaine (10 mg) Combined with Different Adjuvants. Background and objectives:Combination of local anesthetics (LA) with adjuvants for spinal anesthesia improves block quality and prolongs the duration of analgesia. It was evaluated the maternal effects and neonatal repercussions of sufentanil, morphine, and clonidine combined with hyperbaric bupivacaine for elective cesarean section.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 95%

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Raquianestesia em operação cesariana. Emprego da associação de bupivacaína hiperbárica (10 mg) a diferentes adjuvantes

Braga¹,

Frias²,

Braga³

et al. 2012

Rev. Bras. Anestesiol.

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“…[1,2] Managing spinal anaesthesia that is inadequate for surgery can be extreme ly challenging; doctors need to be aware of all the possible reasons for failure. The anaesthetic technique must maximise the chance of success.…”

Section: Researchmentioning

confidence: 99%

Management of failed spinal anaesthesia for caesarean section

Jones¹,

Samuel²,

Biccard³

2017

S Afr Med J

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This was a descriptive, observational cross-sectional study. All obstetric anaesthetic service providers, including specialist anaesthetists, medical officers, registrars, community-service doctors and interns working in 51 government hospitals in KwaZulu-Natal (KZN), SA, were invited to complete a simple questionnaire,* which was structured to Methods.A structured questionnaire to ascertain the current practice of testing the level of block and management of three different scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA). All obstetric anaesthetic service providers, ranging from interns to specialist anaesthetists, were invited to complete the questionnaire. Results.A total of 375 responses were received from 42 of the 51 hospitals surveyed. Specialist anaesthetists managed failure of spinal anaesthesia significantly differently than other anaesthetic service providers. Specialists were more likely to convert to a general anaesthetic (GA), while others were more likely to repeat spinal anaesthesia or administer intravenous ketamine, midazolam and opioids. Only 212 respondents (56%) tested the level of block and there was no difference between the groups with regard to the method of assessment of height (p=0.15). Nonspecialists, however, accepted a significantly lower level of block, using pinprick, than specialists (p=0.027), which could lead to a higher failure rate. More than one-third of non-specialists did not consider themselves competent to perform a GA and >90% of respondents agreed that a 'failed' spinal algorithm would be useful. Conclusion.There is a need for standardised assessment of the adequacy of spinal anaesthesia for CS in SA, as well as a failed spinal algorithm.

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“…16 Benzer şekilde, ça-lışmamızda seksiyo hastalarındaki başarısız blok oranı %6 olarak bulunmuştur. Brun-Buisson ve ark.nın ortopedi hastalarında yaptıkları çalışmada, spinal blok başarısızlık oranı %6,3 olarak saptanmıştır.…”

Section: Bulgularunclassified

The Effective Factors on Block Success

Turan¹,

Bombacı²,

Yılmaz³

et al. 2017

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma ile spinal girişimlerimizdeki başarısızlık oranlarının ve başarısızlığa yol açan nedenlerin ortaya koyulması hedeflemiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmamız bir eğitim ve araştırma hastanesinin ameliyathanelerinde spinal girişim uygulanan hastaların, prospektif incelenmesine dayanmaktadır. Çalışmaya alınan her bir hasta için yaş, cinsiyet, tanı, geçireceği cerrahi, kliniği, uygulayıcının tecrübesi, iğne çapı-tipi, ilaç dozu, deneme sayısı, spinal aralık, ve bloğun sonucu (başarılı/başarısız) kaydedildi. Hastalar, spinal anestezi sonucu başarılı olanlar Grup 1; başarısız olanlar Grup 2 olmak üzere iki gruba ayrıldı. B Bu ul lg gu ul la ar r: : Çalışmaya toplam 1.499 hasta dâhil edildi. Başarısızlık oranımız %6,5 olarak saptandı. Lojistik regresyon analizi yapıldığında yaş, uygulayıcının tecrübesi, iğne tipi, iğne çapı, hasta pozisyonu, lokal anestezik dozu, deneme sayısı bağımsız değişkenler olarak saptandı. Uygulayıcının, kıdemi 1 yıl ve 1 yıldan daha az olan asistanlar olduğu girişimlerde (p:0.0021); yan yatar pozisyonda (p:0.000); 27 gauge ve "pencil point" iğne kullanıldığında (p:0.000) ve girişim sayısının 3 ten fazla olduğu vakalarda (p:0.004) başarısızlık oranı yüksek bulundu. Grup 2'nin yaş ortalaması da Grup 1'e oranla anlamlı derecede yüksek bulundu p(0.000). S So on nu uç ç: : Spinal anestezi uygulamalarında teknik sebeplere ve uygulayıcı deneyim eksikliğine bağlı başarısızlıklar sıklıkla görülmektedir. İğne tipi, iğne çapı, hasta pozisyonu, lokal anestezik dozu, uygulayıcının tecrübesi, çalışmamızda başarısız sonucu etkileyen faktörlerdir. Uygulayıcının tecrübesinin artırılması ve kullanılan malzeme seçiminde daha dikkatli olunması durumunda başarısız blok oranının minimuma indirilebileceği sonucuna varılmıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Anestezi, spinal; anestezi, genel; enjeksiyonlar, spinal; sinir bloğu A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to analyze the incidence and reasons of failure for spinal anesthesia. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This study was designed prospectively in an education and research hospital. Data of patients operated with spinal anesthesia in one year's time were recorded. Age, gender, type of surgery, the practitioner's level of experience, needle gauge and type, dosage and density of the local anesthetic, number of puncture attempts, level of puncture, and results of the intervention (failure/success) were recorded for each patient. R Re es su ul lt ts s: A total of 1.499 patients were included in the study. The overall spinal failure rate was 6.5%. The patients were divided into two groups as Group 1 with successful and Group 2 with failed spinal anesthesia. With logistic regression analysis of the data of age, level of experience, needle type and gauge, patient position, local anesthetic dosage and the number of puncture attempts were found as independent variables of the failure. Less than 1 year pract...

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An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section

Cited by 47 publications

References 27 publications

Raquianestesia em operação cesariana. Emprego da associação de bupivacaína hiperbárica (10 mg) a diferentes adjuvantes

Raquianestesia em operação cesariana. Emprego da associação de bupivacaína hiperbárica (10 mg) a diferentes adjuvantes

Management of failed spinal anaesthesia for caesarean section

The Effective Factors on Block Success

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