T P Juhani1, H Hannele. 1. Department of Clinical Sciences, Tampere University, Finland.
Abstract
BACKGROUND AND OBJECTIVES: To evaluate the incidence and causes of complications associated with spinal anesthesia for cesarean delivery. METHODS: Prospective study, case series. SETTING: Tampere University Hospital, 284 patients scheduled for elective or nonelective cesarean delivery with spinal anesthesia. Complications occurring during spinal anesthesia with hyperbaric 0.5% bupivacaine during a 1-year period were analyzed. RESULTS: Hyperbaric 0.5% bupivacaine for cesarean delivery proved to be a reliable anesthetic with a failure rate of 2.8%. The most common complications were hypotension (42%) and nausea (14%). In 81% of patients, hypotensive periods occurred before delivery. Hypotension before delivery had no correlation with low Apgar scores or with low pH in the umbilical artery of the infant. Risk factors for hypotension were elective procedures and operations without prophylactic ephedrine infusion. Nausea occurred significantly more often if a lower interspace was used for administering the subarachnoid block. CONCLUSIONS: Spinal anesthesia proved to be a safe, reliable, and rapid method of anesthesia for cesarean delivery, but, in view of a high incidence of minor complications, careful patient monitoring during spinal anesthesia is necessary to make the outcome optimal for mother and fetus.
BACKGROUND AND OBJECTIVES: To evaluate the incidence and causes of complications associated with spinal anesthesia for cesarean delivery. METHODS: Prospective study, case series. SETTING: Tampere University Hospital, 284 patients scheduled for elective or nonelective cesarean delivery with spinal anesthesia. Complications occurring during spinal anesthesia with hyperbaric 0.5% bupivacaine during a 1-year period were analyzed. RESULTS: Hyperbaric 0.5% bupivacaine for cesarean delivery proved to be a reliable anesthetic with a failure rate of 2.8%. The most common complications were hypotension (42%) and nausea (14%). In 81% of patients, hypotensive periods occurred before delivery. Hypotension before delivery had no correlation with low Apgar scores or with low pH in the umbilical artery of the infant. Risk factors for hypotension were elective procedures and operations without prophylactic ephedrine infusion. Nausea occurred significantly more often if a lower interspace was used for administering the subarachnoid block. CONCLUSIONS: Spinal anesthesia proved to be a safe, reliable, and rapid method of anesthesia for cesarean delivery, but, in view of a high incidence of minor complications, careful patient monitoring during spinal anesthesia is necessary to make the outcome optimal for mother and fetus.