Factors Associated With Failed Spinal Anesthesia for Cesarean Delivery

Mahidol University

Status: Completed

Conditions: Cesarean Section Complications; Anesthesia; Adverse Effect

Treatments: Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine

Study type: Observational

Funder types: Other

Identifiers

NCT04685980

445/2020 (Other Identifier)

290/2563 (EC1)

Details and patient eligibility

About

The aim of this study is to reveal the factor associated with failed spinal anaesthesia in cesarean delivery. We conduct the retrospective case-control study to elucidate the involving factors.

Full description

Spinal anaesthesia is the anaesthetic technique of choice of patients undergoing cesarean delivery due to its rapid onset, good reliability and good efficacy. However, the inadequate or failed spinal anaesthesia can occur. The previous literatures revealed incidence of failed spinal anaesthesia was as high as 0.5-6%. Failure of spinal anaesthesia leads to numerous maternal and neonatal consequences. Those failed spinal anaesthesia patients required general anaesthesia with endotracheal tube which may cause several complications such as hypoxia, difficult intubation, failed intubation and pulmonary aspiration. Also, a recent network meta-analysis showed general anaesthesia decreasing neonatal Apgar score.

The factors that associated with failed spinal anaesthesia in cesarean delivery has been studied. The amount of local anaesthetic, needle type, patients' body mass index (obesity), and experiences of the anaesthetist performing spinal block influenced the failure of spinal anaesthesia. The details and factors of failed spinal anaesthesia in our hospital was scarce. It has not yet been published in the literature.

Therefore, the aim of this study is to reveal the factor associated with failed spinal anaesthesia in cesarean delivery. We conduct the retrospective case-control study to elucidate the involving factors.

Enrollment: 440 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age >,= 18 years
• Undergoing cesarean delivery
• Failed spinal anaesthesia and received general anaesthesia with endotracheal tube

Exclusion criteria

• Gestational age < 24 weeks
• Received combined spinal-epidural anaesthesia
• Received peripheral nerve blockade

Trial design

440 participants in 2 patient groups

Failed spinal anaesthesia group

Description:

Failed spinal anaesthesia: failure of anaesthetic level of blockade both sensory and motor blockage, and consequently receive general anaesthesia

Treatment:

Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine

Control Group

Description:

Patient receiving spinal anaesthesia and successfully finish the cesarean section

Treatment:

Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine