A failed spinal algorithm can guide the anaesthesiologist in choosing alternative options and help reduce morbidity and mortality during caesarean section.
What is the appropriate clinical approach to managing failed spinal anaesthesia for caesarean section?
A structured algorithm for managing failed spinal anaesthesia during caesarean section can help guide clinical decision-making and reduce maternal and neonatal morbidity.
Failure of spinal anaesthesia for caesarean section may have deleterious consequences for the mother as well as the newborn baby. In this article, we discuss the mechanisms of failure of spinal anaesthesia as well as the approach to a failed block. We performed a literature search in Google Scholar, PubMed, and Cochrane databases for original and review articles concerning failed spinal anaesthesia and caesarean section. Strategies for a failed spinal anaesthetic include manoeuvers to salvage the block, repeating the block, epidural anaesthesia or a combined spinal-epidural (CSE) technique, or resorting to general anaesthesia. Factors influencing the choice of these alternative options are discussed. A "failed spinal algorithm" can guide the anaesthesiologist and help reduce morbidity and mortality.
Parikh et al. (2018) conducted a review in Failed spinal anaesthesia for caesarean section. Strategies for a failed spinal anaesthetic was evaluated. A failed spinal algorithm can guide the anaesthesiologist in choosing alternative options and help reduce morbidity and mortality during caesarean section.