FAILED SPINAL ANESTHESIA

THE INCIDENCE IN A POSTGRADUATE TEACHING HOSPITAL

Abstract

Objectives: 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 2nd 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%