A Retrospective Study of the Incidence and Causes of Failed Spinal Anesthetics in a University Hospital
- 1 July 1985
- journal article
- research article
- Published by Wolters Kluwer Health in Anesthesia & Analgesia
- Vol. 64 (7) , 705???710-710
- https://doi.org/10.1213/00000539-198507000-00010
Abstract
Sequential spinal anesthetic procedures were reviewed retrospectively to study specifically the incidence and causes of spinal anesthesia. Variables examined included the patient population, the technical aspects of performing subarachnoid tap and subsequent blockade, and the level of training of the anesthetists. A 17% incidence of spinal failure, defined as the need to use general anesthesia during the surgical procedure was found. Failure was significantly associated with a lack of free flow of CSF, the use of tetracaine without epinephrine, and an increased administration of i.v. supplementation. Forty-one percent of the failures represented errors in judgement, either in not properly anticipating the duration of surgery or injecting local anesthetic solution in the absence of a free flow of CSF. An incidental finding was the lack of documentation in many of the variables examined. The high incidence of failed spinal anesthesia is attributed mainly to technical reasons, most of them avoidable. The use of local and regional anesthesia requires considerable technical skills and demands a precise and total understanding of regional anatomic relationships. With the decreasing use of regional anesthesia in operating rooms, only those regional anesthesia techniques that require minimum dexterity, such as spinal and epidural anesthesia, continue to be utilized widely; and even these techniques, safe as they are, are being poorly taught.This publication has 1 reference indexed in Scilit: