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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
PubMed

Failure of spinal anaesthesia for caesarean section may have deleterious consequences for the mother as well as the newborn baby. In this article, we discuss the mechanisms of failure of spinal anaesthesia as well as the approach to a failed block. We performed a literature search in Google Scholar, PubMed, and Cochrane databases for original and review articles concerning failed spinal anaesthesia and caesarean section. Strategies for a failed spinal anaesthetic include manoeuvers to salvage the block, repeating the block, epidural anaesthesia or a combined spinal-epidural (CSE) technique, or resorting to general anaesthesia. Factors influencing the choice of these alternative options are discussed. A "failed spinal algorithm" can guide the anaesthesiologist and help reduce morbidity and mortality.

Keywords:
Caesarean sectionfailed spinalgeneral anaesthesiarepeat spinalsafe practice

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