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Approach to failed spinal anaesthesia for caesarean section
Ketan S Parikh1,2, Shwetha Seetharamaiah3
1Department of Anesthesia, Breach Candy Hospital, Mumbai, Maharashtra, India.
Indian Journal of Anaesthesia
|September 22, 2018
Summary
Failed spinal anesthesia during cesarean delivery can harm mother and baby. This review outlines strategies like salvaging the block, re-blocking, or switching to general anesthesia to manage failed spinal anesthesia effectively.
Area of Science:
- Anesthesiology
- Obstetric Anesthesia
Background:
- Spinal anesthesia is a common technique for cesarean sections.
- Failure of spinal anesthesia can lead to adverse outcomes for both mother and neonate.
Purpose of the Study:
- To review the mechanisms of spinal anesthesia failure in cesarean delivery.
- To outline the management strategies for a failed spinal block.
Main Methods:
- Literature search conducted in Google Scholar, PubMed, and Cochrane databases.
- Included original and review articles on failed spinal anesthesia and cesarean section.
Main Results:
- Strategies include block salvage, re-administration, epidural, combined spinal-epidural (CSE), or general anesthesia.
- Factors influencing the choice of alternative techniques are discussed.
Conclusions:
- A structured "failed spinal algorithm" can guide anesthesiologists.
- Implementing such an algorithm may reduce maternal and neonatal morbidity and mortality.
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