Conversion of regional to general anaesthesia for caesarean section - A one-year prospective observational study

Background: General anaesthesia for caesarean delivery is associated with substantially greater maternal risk than regional anaesthesia. Most of the deaths occurring during general anaesthesia are related to airway management or aspiration. Spinal and epidural anaesthesia have therefore become more common in obstetric surgical practice. Objectives: A one year prospective observational study of caesarean sections (CS) carried out under regional anaesthesia was analysed to know the 1. Incidence and characteristics of failed regional anaesthesia leading to conversion of regional to general anaesthesia (Total/Partial “Failure” of block) in CS. 2. Identification of risk factors for “block failure ”3. To identify the options used for managing an inadequate block. Methods: The present study was conducted in Anaesthesia Department of Panna Dhai Women Hospital attached to R.N.T. Medical College from 1st Feb. 2011 to 31st Jan.2012. Regional anaesthesia technique for CS included spinal (most common), epidural and combined spinal epidural (CSE) technique. Results: Incidence of failed spinal anaesthesia was 77/4038 (1.906%) [52/ 4038; 1.287% -partial spinal failure and 25/4038; 0.62%complete spinal failure]. There was no case of failure observed in epidural or CSE. Failure rate was 13/1674 (0.77) for elective CS and 64/2403 (2.66%) for emergency CS. Conclusion; Spinal anaesthesia using hyperbaric bupivacaine produced reliable anaesthesia for caesarean section with failure rate of 0.77% in elective surgery and 2.66% in emergency surgery. Key Word: Regional anaesthesia, CS, SAB, CSE, General anaesthesia *Address for Correspondence: Dr. Devendra Kumar Bohra, Department of Anaesthesia, Dr SN Medical College, Jodhpur, Rajasthan, INDIA. Email: dr.dharmendrapipal2007@gmail.com Received Date: 02/03/2019 Revised Date: 30/04/2019 Accepted Date: 22/06/2019 DOI: https://doi.org/10.26611/1015111210