Spinal anaesthesia with hyperbaric lignocaine for elective Caesarean section

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Abstract
This study was carried out in 30 patients undergoing elective Caesarean section to assess the predictability and reliability of spinal anaesthesia with 5% hyperbaric lignocaine, with a view to incorporating the technique in our failed intubation drill. The spinal was performed with a 25-gauge needle in either the sitting (15 patients) or left lateral position (15 patients). The speed of onset of anaesthesia to T6 was significantly faster (p less than 0.01) in the lateral group, but the duration of action was similar in both groups. Twelve patients had hypotension and four developed severe postspinal headaches. The block progressed to the C2 dermatome in four patients and was associated with dysphagia. This was totally unpredictable and may be due to altered cerebrospinal fluid dynamics in late pregnancy. Therefore, the use of spinal anaesthesia with heavy lignocaine may be inadvisable in obstetric patients, especially following failed intubation.

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