Key result
Cesarean spinal anesthesia with hyperbaric bupivacaine shows a 2.8% failure rate, primarily complicated by hypotension.
Why the study?
The incidence and causes of complications associated with spinal anesthesia for cesarean delivery were evaluated to inform clinical practice.
Observational (n=284)
No
Spinal anesthesia with hyperbaric 0.5% bupivacaine for cesarean delivery is reliable but frequently causes minor complications such as hypotension and nausea, necessitating careful monitoring.
Supports careful monitoring for hypotension and nausea with spinal bupivacaine in cesarean delivery; leaves open validation in larger cohorts.
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.
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Juhani et al. (1993) conducted an observational in Cesarean delivery (n=284). Spinal anesthesia with hyperbaric 0.5% bupivacaine was evaluated on Incidence and causes of complications associated with spinal anesthesia. Spinal anesthesia with hyperbaric 0.5% bupivacaine for cesarean delivery had a 2.8% failure rate, with hypotension (42%) and nausea (14%) being the most common complications.
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