Continuous spinal anaesthesia: A retrospective analysis of 318 cases

Area of Science:

• Anesthesiology
• Surgical Procedures
• Patient Safety

Background:

• Continuous spinal anaesthesia (CSA) is an underutilized anesthetic method.
• Evaluation of CSA's institutional use, efficacy, ease, and safety is warranted.

Purpose of the Study:

• To assess the utilization, efficacy, ease of use, and safety of continuous spinal anaesthesia (CSA).

Main Methods:

• Retrospective analysis of patients receiving CSA between December 2008 and July 2017 in a tertiary care center.
• Analysis of demographic profiles, surgical types, duration, CSA success rates, technical difficulties, hemodynamic data, vasopressor use, and complications.
• Statistical analysis using the Chi-square test.

Main Results:

• 94% of patients (318/338) successfully underwent surgery with CSA.
• 6% (20/338) experienced CSA failure, including insertion failure or conversion to general anaesthesia.
• Initial intrathecal local anaesthetic (LA) volume ≥1.5 ml significantly increased hypotension risk (OR 2.78; 95% CI, 1.70-4.57).
• No cases of post-dural puncture headache, neurological sequelae, or infection were reported.

Conclusions:

• Continuous spinal anaesthesia (CSA) is a viable anesthetic technique with a low failure rate.
• Hemodynamic stability during CSA is achieved by administering a small initial LA bolus and titrating with small aliquots.
• This approach ensures effective anesthesia while minimizing adverse events.