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Related Experiment Videos

Spinal anaesthesia with hyperbaric lignocaine for elective caesarean section.

M Bembridge, R Macdonald, G Lyons

    Anaesthesia
    |September 1, 1986
    PubMed
    Summary

    Spinal anesthesia with hyperbaric lignocaine in Cesarean sections showed faster onset in the lateral position but unpredictable high-level blocks. This technique may be unsuitable for obstetric patients, particularly after failed intubation.

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    Area of Science:

    • Anesthesiology
    • Obstetric Anesthesia
    • Regional Anesthesia

    Background:

    • Evaluating spinal anesthesia techniques for Cesarean sections is crucial for patient safety and surgical success.
    • Failed intubation drills necessitate reliable anesthetic methods for emergency Cesarean deliveries.

    Purpose of the Study:

    • To assess the predictability and reliability of spinal anesthesia using 5% hyperbaric lignocaine in patients undergoing elective Cesarean section.
    • To determine the suitability of this technique for integration into failed intubation protocols in obstetric care.

    Main Methods:

    • A comparative study involving 30 patients undergoing elective Cesarean section.
    • Spinal anesthesia administered with a 25-gauge needle in either the sitting (n=15) or left lateral (n=15) position.

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  • Assessment of anesthetic onset speed, duration, and adverse events.

    • Main Results:

    • Significantly faster onset of anesthesia to the T6 dermatome was observed in the lateral position group (p < 0.01).
    • Hypotension occurred in 12 patients, and 4 experienced severe postspinal headaches.
    • Unpredictable high-level spinal block (to C2 dermatome) with dysphagia occurred in 4 patients, potentially linked to altered cerebrospinal fluid dynamics in late pregnancy.

    Conclusions:

    • While spinal anesthesia with hyperbaric lignocaine offers a faster onset in the lateral position, its unpredictable high-level block potential and associated adverse events raise concerns.
    • The technique may be inadvisable for obstetric patients, especially as a component of failed intubation drills, due to safety concerns.
    • Further research is needed to understand and mitigate the risks of unpredictable block progression in obstetric anesthesia.