Plea for greater use of spinal anaesthesia in developing countries

When it is indicated for surgical procedures below the umbilicus in our low-resource countries, spinal anaesthesia has many advantages: it is simple, cheap, safe and easy to learn and carry out. It reduces nursing load and the risk of aspiration pneumonitis as well as overall postoperative mortality and morbidity. We prospectively carried out a study of 419 patients operated under spinal anaesthesia during our normal surgical activities. Despite the materials and conditions that were not always those recommended in the published literature, we had very satisfactory results with: (1) a high patient acceptance rate (93.9%); (2) relatively rare adverse effects - the most frequent being hypotension and vomiting each observed in seven (1.67%) patients. We had two cases (0.48%) of the rare cauda equina syndrome. In poor-resource countries, the culture of spinal anaesthesia should be better developed and encouraged by the training institutions.