Frequency of Failed Spinal Anesthesia and Associated Factors in Cesarean Section at Mardan Medical Complex, Mardan, KP, Pakistan

Year : 2024 | Volume : 02 | Issue : 02 | Page : 1 9
    By

    Shabir Ahmad,

  • Abdul Qadeer,

  • Roohul Amin,

  • Saeed Anwar,

  • Hamid Ullah,

  • Omama Akmal,

  • Tahir Khan,

  1. Anesthesia Technologist, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan
  2. Lecturer Anesthesia, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan
  3. Lecturer Statistics, Government Girls Post Graduate College, Khyber Pakhtunkhwa, Pakistan
  4. Anesthetist, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan
  5. Anesthesia Technologist, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan
  6. Anesthesia Technologist, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan
  7. Anesthesia Technologist, Mardan Medical Complex (MTI), Hospital in Mardan, Khyber Pakhtunkhwa, Pakistan

Abstract

Objective: Spinal anesthesia is the preferred choice of anesthesia for parturients having cesarean sections. Despite the high percentage of success in providing acceptable surgical anesthesia, failure of spinal anesthesia has been reported. This study aims to determine the frequency and associated factors related to failed spinal anesthesia during cesarean sections in pregnant women. Methodology: This descriptive cross-sectional study included 149 pregnant women and was conducted at Mardan Medical Complex (MMC) between April and September 2023. Pregnant women having cesarean sections elective or emergency were administered 10–15 mg of 0.75% hyperbaric bupivacaine using a 23–25G Quincke spinal needle. A pre-designed questionnaire was used to document patient demographics, clinical details, as well as spinal anesthesia details of each patient. All the variables were analyzed with the help of SPSS version 22. Results: Among the 149 pregnant women who received spinal anesthesia, 17 (11.4%) experienced “failed” outcomes, where the spinal anesthesia did not work as intended. Conversely, 132 (88.6%) had “successful” outcomes, indicating effective administration of spinal anesthesia. A portion of 11 (8.7%), represented “partial failure,” where the anesthesia had some success but did not achieve adequate anesthesia. While complete failure accounted for 4 (2.7%) of cases, signifying instances where spinal anesthesia did not work completely. Conclusion and Recommendations: The frequency of failed spinal anesthesia in pregnant women undergoing cesarean section at MMC was high at 11.40%.

Keywords: Cesarean section, spinal anesthesia, failed spinal anesthesia, associated factors

[This article belongs to International Journal of Women’s Health Nursing And Practices ]

How to cite this article:
Shabir Ahmad, Abdul Qadeer, Roohul Amin, Saeed Anwar, Hamid Ullah, Omama Akmal, Tahir Khan. Frequency of Failed Spinal Anesthesia and Associated Factors in Cesarean Section at Mardan Medical Complex, Mardan, KP, Pakistan. International Journal of Women’s Health Nursing And Practices. 2024; 02(02):1-9.
How to cite this URL:
Shabir Ahmad, Abdul Qadeer, Roohul Amin, Saeed Anwar, Hamid Ullah, Omama Akmal, Tahir Khan. Frequency of Failed Spinal Anesthesia and Associated Factors in Cesarean Section at Mardan Medical Complex, Mardan, KP, Pakistan. International Journal of Women’s Health Nursing And Practices. 2024; 02(02):1-9. Available from: https://journals.stmjournals.com/ijwhnp/article=2024/view=191917


References

  1. Punchuklang W, Nivatpumin P, Jintadawong T. Total failure of spinal anesthesia for cesarean delivery, associated factors, and outcomes: A retrospective case-control study. Medicine. 2022;101:e29813. doi: 10.1097/MD.0000000000029813. PubMed: 35801788.
  2. At A, So O. Failed spinal anaesthesia for caesarean section. J West Afr Coll Surg. 2011 Oct;1(4):1-17. PMID: 25452968; PMCID: PMC4170277.
  3. Alabi AA, Adeniyi OV, Adeleke OA, Pillay P, Haffajee MR. Factors associated with failed spinal anesthesia for cesarean sections in Mthatha General Hospital, Eastern Cape, South Africa. S Afr Fam Pract. 2017;59(4):128–32. doi: 10.1080/20786190.2017.1292696.
  4. Cooper GM, McClure JH. Maternal deaths from anaesthesia. An extract from Why Mothers Die 2000–2002, the Confidential Enquiries into Maternal Deaths in the United Kingdom: Chapter 9: Anaesthesia. Br J Anaesth. 2005;94:417–23. doi: 10.1093/bja/aei066. PubMed: 15758081.
  5. Kinsella SM. A prospective audit of regional anaesthesia failure in 5080 Caesarean sections. Anaesthesia. 2008;63:822–32. doi: 10.1111/j.1365-2044.2008.05499.x. PubMed: 18547291.
  6. Ashagrie HE, Ahmed SA, Melesse DY. The incidence and factors associated with failed spinal anesthesia among parturients underwent cesarean section, 2019: A prospective observational study. Int J Surg Open. 2020;24:47–51. doi: 10.1016/j.ijso.2020.03.009.
  7. Rukewe A, Adebayo OK, Fatiregun AA. Failed obstetric spinal anesthesia in a Nigerian teaching hospital: Incidence and risk factors. Anesth Analg. 2015;121:1301–5. doi: 10.1213/ANE.0000000000000868. PubMed: 26218861.
  8. No BZ. Subjective failed spinal anesthesia in cesarean section; Type, management, and associated factors. Res Artic J Anesth Clin Res. 2022;13(3):1001048.
  9. Colvin JR, Peden CJ, editors. Raising the Standard: a Compendium of Audit Recipes for Continuous Quality Improvement in Anaesthesia. 3rd ed. London: The Royal College of Anaesthetists; 2012.
  10. Levy JH, Islas JA, Ghia JN, Turnbull C. A retrospective study of the incidence and causes of failed spinal anesthetics in a University Hospital. Anesth Analg. 1985;64:705–10. doi: 10.1213/00000539-198507000-00010. PubMed: 4014732.
  11. Bekele Z, Jisha H. Type, management, and associated factors of failed spinal anesthesia in cesarean section. Prospective cohort study. Ann Med Surg. 2022;77:103616. doi: 10.1016/j.amsu.2022.103616. PubMed: 35638059.
  12. Fettes PDW, Jansson JR, Wildsmith JAW. Failed spinal anaesthesia: Mechanisms, management, and prevention. Br J Anaesth. 2009;102:739–48. doi: 10.1093/bja/aep096. PubMed: 19420004.
  13. Wenk M, Weiss C, Möllmann M, Pöpping DM. Procedural complications of spinal anaesthesia in the obese patient. Anesthesiol Res Pract. 2012;2012:165267. doi: 10.1155/2012/165267. PubMed: 22899910.
  14. Kilawe A. Prevalence and factors associated with failed spinal anesthesia in failed spinal anesthesia undergoing cesarean section at Muhimbili National Hospital Dar-Es-Salaam. Tanzania. 2019.
  15. Halimi NN, Basit M, Waqas HM, Khan MJ, Ilyas M. To determine the frequency of failed spinal anaesthesia during cesarean section. Pak J Surg. 2020;36(1):71–4.
  16. Partani S, Singhal Y, Gupta S. A prospective, observational audit of failed regional anaesthesia in 4085 caesarean sections at a tertiary care hospital. Indian J Clin Anaesth. 2018;5(1):50–5. DOI: 10.18231/2394-4994.2018.0009.
  17. Alabi AA, Adeniyi OV, Adeleke OA, Pillay P, Haffajee MR. Factors associated with failed spinal anesthesia for cesarean sections in Mthatha General Hospital, Eastern Cape, South Africa. S Afr Fam Pract. 2017;59(4):128–32.
  18. At A, So O. Failed spinal anaesthesia for caesarean section. J West Afr Coll Surg. 2011 Oct;1(4):1-17. PMID: 25452968; PMCID: PMC4170277.
  19. Nani FS, Torres ML. Correlation between the body mass index (BMI) of pregnant women and the development of hypotension after spinal anesthesia for cesarean section. Rev Bras Anestesiol. 2011 Jan-Feb;61(1):21-30. doi: 10.1016/S0034-7094(11)70003-4. PMID: 21334504.
  20. Dresner MR, Freeman JM. Anaesthesia for caesarean section. Best Pract Res Clin Obstet Gynaecol. 2001 Feb;15(1):127-43. doi: 10.1053/beog.2000.0153. PMID: 11359319.
  21. Ružman T, Gulam D, Haršanji Drenjančević IH, Venžera-Azenić D, Ružman N, Burazin J. Factors associated with difficult neuraxial blockade. Local Reg Anesth. 2014;7:47–52. doi: 10.2147/LRA.S68451. PubMed: 25336987.
  22. Sng BL, Lim Y, Sia ATH. An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section. Int J Obstet Anesth. 2009;18:237–41. doi: 10.1016/j.ijoa.2009.01.010. PubMed: 19450971.
Regular Issue Subscription Original Research
Volume 02
Issue 02
Received 16/08/2024
Accepted 10/10/2024
Published 25/10/2024
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