Procedural Complications of Spinal Anaesthesia in the Obese Patient

Abstract

Background. Complications of spinal anaesthesia (SpA) range between 1 and 17%. Habitus and operator experience may play a pivotal role, but only sparse data is available to substantiate this claim. Methods. 161 patients were prospectively enrolled. Data such as spread of block, duration of puncture, number of trials, any complication, operator experience, haemodynamic parameters, was recorded and anatomical patient habitus assessed. Results. Data from 154 patients were analyzed. Success rate of SpA in the group of young trainees was 72% versus 100% in the group of consultants. Trainees succeeded in patients with a normal habitus in 83.3% of cases versus 41.3% when patients had a difficult anatomy (P = 0.02). SpA in obese patients (BMI ≥ 32) was associated with a significantly longer duration of puncture, an increased failure ratio when performed by trainees (almost 50%), and an increased number of bloody punctures. Discussion. Habitus plays a pivotal role for SpA efficiency. In patients with obscured landmarks, failure ratio in unexperienced operators is high. Hence, patient prescreening as well as adequate choice of operators may be beneficial for the success rate of SpA and contribute to less complications and better patient and trainee satisfaction.

A Retrospective Study to Evaluate the Incidence and Factors Influencing Failed Spinal Anaesthesia in Women Undergoing Caesarean Section

“…Overweight patients (BMI ≥25) had increased rate of failure which may be due to technical difficulty in locating the space. A similar finding was described in the study conducted by Manuel et al [8]. High failure rate seen in patients having labour pain is usually because of the difficulty in positioning and movements of patient during drug injection.…”

Frequent Spinal Anesthesia in a Patient with Traumatic Lower Extremity Injury: A Case Report

“…Like other anesthesia techniques, spinal anesthesia is not free of complications (4). The complication rates of spinal anesthesia have been reported from 1% to 17%, depending on the experience of anesthesiologists performing the procedure and the definition of a complication (5). The complications of spinal anesthesia include hypotension, bradycardia, nausea and vomiting, urinary retention, insufficient block, hematoma or abscess around the injection site, post-dural puncture headache (PDPH), septic or aseptic meningitis, back pain, arachnoiditis, and neurologic sequelae.…”

Спинальная Анестезия У Детей (Обзор Литературы)

“…Ожирение, как правило, осложняет выполнение СА. В г. Мюнстере, Германия, Wenk и соавт., пронаблюдав 154 взрослых пациента, пришли к выводу, что индекс массы тела  32 связан с большей длительностью выполнения спинальной пункции и, при выполнении стажерами, почти 50 % случаев с получением крови при пункции, а в 41,3 % случаев -с неудачной пункцией [83]. Логично предположить, что у детей будет наблюдаться подобная закономерность, но подобных исследований в отношении детей нами не найдено.…”