Adverse effects of spinal anaesthesia for caesarean section
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20230675Keywords:
Bupivacaine, Spinal anaesthesia, Caesarean section, ShiveringAbstract
Background: Obstetric anaesthetists while providing anaesthesia for caesarean sections, provide care for both the mother and the unborn baby. This study was performed to evaluate the adverse effects of spinal anaesthesia for Caesarean section.
Methods: The present study is a prospective observational study carried out on 100 full-term, low risk pregnant patients who had caesarean section under spinal anaesthesia at Varun Arjun medical college, Shahjahanpur, U. P., India from January 2022 to December 2022.
Results: In our study, 43 (43%) patients were between 26-30 years, 32 (32%) patients were between 31-35 years, 16 (16%) patients were between 36-40 years. The 62 (62%) patients were primigravida while 38 (38%) patients were multigravida. The 66 (66%) patients were delivered by emergency caesarean section while 34 (34%) were delivered by emergency caesarean section. In our study, adverse anaesthetic effects were less. 12 (12%) patients had spinal hypotension, 11 (11%) patients had spinal headache, 10 (10%) patients had pruritus, 9 (9%) patients had shivering, 5 (5%) patients had nausea and vomiting, 4 (4%) patients had less visceral pain and neonatal Apgar score each, 3 (3%) patients had failed regional anaesthesia, 3 (3%) patients had bradycardia while 2 (2%) patients had high spinal anaesthesia, 10 (10%) patients had visceral pain.
Conclusions: In our study, combination of bupivacaine and a low dose of fentanyl (0.25 μg/kg) provided excellent surgical anaesthesia with short-lasting postoperative analgesia. There were very few adverse side effects.
References
Zhang F, Cheng J, Yan S, Wu H, Bai T. Early feeding behaviours and breastfeeding outcomes after caesarean section. Breastfeeding Med. 2019;14(5):325-33.
Fernandes NL, Dyer RA. Anaesthesia for urgent caesarean section. Clin Perinatol. 2019;46(4):785-99.
Shah OM, Bhat KM. Comparison of the efficacy and safety of morphine and fentanyl as adjuvants to bupivacaine in providing operative anaesthesia and postoperative analgesia in subumblical surgeries using combined spinal epidural technique. Anaesthesia, Essays Res. 2017;11(4):913-20.
Ferrarezi WPP, Braga AFA, Ferreira WB. Spinal anaesthesia for elective caesarean section. Bupivacaine associated with different doses of fentanyl: randomized clinical trial. Braz J Anaesthesiol. 2021;71(6):642-8.
Practice Guidelines for Obstetric Anaesthesia: An Updated Report by the American Society of Anaesthesiologists Task Force on Obstetric Anaesthesia and the Society for Obstetric Anaesthesia and Perinatology. Anaesthesiology. 2016;124:270.
Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM: Anaesthesia-related maternal mortality in the United States: 1979-2002. Obstet Gynecol. 2011;117:69-74.
Juang J, Gabriel RA, Dutton RP, Palanisamy A, Urman RD. Choice of anaesthesia for caesarean delivery: An analysis of the National Anaesthesia Clinical Outcomes Registry. Anesth Analg. 2017;124:1914-7.
Uppal V, McKeen DM. Strategies for prevention of spinal-associated hypotension during Caesarean delivery: Are we paying attention? Can J Anaesth. 2017;64:991-6.
Uppal V, Retter S, Casey M. Efficacy of intrathecal fentanyl for caesarean delivery: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Anesth Analg. 2020;130:111-25.
Reynolds F, Seed PT. Anaesthesia for caesarean section and neonatal acid-base status: a meta-analysis. Anaesthesia. 2005;60(7):636–53.
Gaiser R. Anaesthetic considerations in the obese parturient. Clin Obstet Gynecol. 2016;59(1):193-203.
Wilson RD, Caughey AB, Wood SL, Macones GA, Wrench IJ, Huang J et al. Guidelines for Antenatal and Preoperative care in Caesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). Am J Obstet Gynecol. 2018;1.
Silva IG, Diogenes RS, Araujo IG, Lima AM, Morais AC. Analysis of suspected adverse reactions to anaesthetic drugs during caesarean delivery in a cohort of women from a teaching maternity hospital in Ceará (Brazil). Rev Bras Farm Hosp Servo Sauce. 2022;13(4):843.
Gupta M, Garg V. The rate and indications of caesarean section in a teaching hospital at Jaipur, India. Int J Reproof Contracept Ofsted Gynecol. 2017;6:1786-92.
Liu X, Zhang X, Wang X, Wang J, Wang H. Comparative evaluation of intrathecal bupivacaine alone and bupivacaine combined with dexmedetomidine in caesarean section using spinal anaesthesia: a meta-analysis. J Int Med Res. 2019;47(7):2785-99.
Karacaer F, Biricik E, Ünal İ. Does prophylactic ondansetron reduce norepinephrine consumption in patients undergoing caesarean section with spinal anaesthesia? J Anesth. 2018;32:90-7.
Manouchehrian N, Bakhshaei MH. Nitrous oxide effect on relieving anxiety and pain in parturients under spinal anaesthesia for caesarean section. Anesth Pain Med. 2014;4(2):e16662.
Frölich MA, Burchfield DJ, Euliano TY, Caton D. A single dose of fentanyl and midazolam prior to Caesarean section have no adverse neonatal effects. Can J Anaesth. 2006;53(1):79-85.
