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Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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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
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.

Keywords:
Caesarean sectionfailed spinalgeneral anaesthesiarepeat spinalsafe practice

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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.