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Failure of subarachnoid block in caesarean section
A B Shrestha1, C K Shrestha, K R Sharma
1Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal. amirbabu@gmail.com
Nepal Medical College Journal : NMCJ
|September 23, 2009
Summary
Subarachnoid block is a safe anesthesia for Cesarean sections, but failure occurs in 6.0% of cases. Further anesthetic agents or conversion to general anesthesia may be required when subarachnoid block is ineffective.
Area of Science:
- Anesthesiology
- Obstetrics
Background:
- Subarachnoid block is a preferred anesthesia for Cesarean sections due to its safety and convenience.
- However, instances of subarachnoid block failure necessitate alternative anesthetic approaches.
Purpose of the Study:
- To determine the failure rate of subarachnoid block in Cesarean sections.
- To identify the causes contributing to subarachnoid block failure in this patient population.
Main Methods:
- A prospective study involving 2039 female patients undergoing Cesarean section.
- Standardized subarachnoid block technique using 26-gauge Sprotte spinal needle and 0.5% hyperbaric Bupivacaine.
- Data collection on anesthetic requirements and conversion rates.
Main Results:
- A 6.0% (n=123) overall failure rate of subarachnoid block was observed.
- Conversion to general anesthesia was required in 4.3% (n=87) of patients.
- An additional 1.8% (n=36) of patients received intravenous agents for completion of the surgery.
Conclusions:
- While subarachnoid block is generally effective for Cesarean sections, a notable failure rate exists.
- Clinicians should be prepared for alternative anesthetic strategies when subarachnoid block is insufficient.
- Understanding failure patterns can optimize anesthetic management during Cesarean delivery.
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