Open AccessApproach to failed spinal anaesthesia for caesarean section
Author(s) -
Ketan Parikh,
Shwetha Seetharamaiah
Publication year - 2018
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/ija.ija_457_18
Subject(s) - medicine , caesarean section , spinal anesthesia , anesthesia , regional anaesthesia , general anaesthesia , pregnancy , surgery , genetics , biology
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.