Failed Spinal Anesthesia; The Incidence in a Postgraduate Teaching Hospital

Abstract

To determine the frequency of failed spinal anesthesia in patients undergoing caesarean section in a teaching hospital in Pakistan. Study Design: It was a cross-sectional study. Setting: Department of Anesthesia and Pain Management PAF Hospital Sargodha. Period: January 2015 to May 2015. Methodology: A total of 293 pregnant patients undergoing caesarean section under spinal anesthesia were included. After prehydration and essential monitoring, all patients were given spinal anesthesia with 25 G spinal needle at L3-L4 or L4-L5 level by 2 nd year resident anesthesiologist under indirect supervision using 1.5 ml of hyperbaric spinal injection. Failure to achieve adequate block was managed by different modalities like sedation, analgesia with ketamine, repeat spinal anesthesia or to proceed with general anesthesia. Results: Out of total of 293 patients, failed spinal occurred in 9 patients (3.07%). Out of these 9 patients, 02 patients (22.22%) were elective caesarean sections while 07 cases (77.77%) were emergency caesarean sections. Conclusion: The chances of failed spinal anesthesia are more in emergency caesarean sections as compared to elective cases and failure rate of spinal anesthesia in PAF teaching hospital Sargodha is 3.07% which is slightly higher than 3%