Factors Associated With Failed Spinal Anesthesia for Cesarean Delivery

Study Overview
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Brief Summary
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The aim of this study is to reveal the factor associated with failed spinal anaesthesia in cesarean delivery. We conduct the retrospective case-control study to elucidate the involving factors.

Detailed Description
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Spinal anaesthesia is the anaesthetic technique of choice of patients undergoing cesarean delivery due to its rapid onset, good reliability and good efficacy. However, the inadequate or failed spinal anaesthesia can occur. The previous literatures revealed incidence of failed spinal anaesthesia was as high as 0.5-6%. Failure of spinal anaesthesia leads to numerous maternal and neonatal consequences. Those failed spinal anaesthesia patients required general anaesthesia with endotracheal tube which may cause several complications such as hypoxia, difficult intubation, failed intubation and pulmonary aspiration. Also, a recent network meta-analysis showed general anaesthesia decreasing neonatal Apgar score. The factors that associated with failed spinal anaesthesia in cesarean delivery has been studied. The amount of local anaesthetic, needle type, patients' body mass index (obesity), and experiences of the anaesthetist performing spinal block influenced the failure of spinal anaesthesia. The details and factors of failed spinal anaesthesia in our hospital was scarce. It has not yet been published in the literature. Therefore, the aim of this study is to reveal the factor associated with failed spinal anaesthesia in cesarean delivery. We conduct the retrospective case-control study to elucidate the involving factors.

Official Title
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Factors Associated With Failed Spinal Anesthesia for Cesarean Delivery, a Retrospective Case-control Study

Conditions
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Anesthesia; Adverse Effect, Cesarean Section Complications

Intervention / Treatment
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* Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >,= 18 years Undergoing cesarean delivery Failed spinal anaesthesia and received general anaesthesia with endotracheal tube Exclusion Criteria: Gestational age < 24 weeks Received combined spinal-epidural anaesthesia Received peripheral nerve blockade

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Failed spinal anaesthesia group<br>Failed spinal anaesthesia: failure of anaesthetic level of blockade both sensory and motor blockage, and consequently receive general anaesthesia | Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine<br>* Patients undergoing cesarean delivery and received spinal anaesthesia with local anaesthetic and intrathecal morphine<br>|
| Control Group<br>Patient receiving spinal anaesthesia and successfully finish the cesarean section | Procedure: spinal anaesthesia with local anaesthetic and intrathecal morphine<br>* Patients undergoing cesarean delivery and received spinal anaesthesia with local anaesthetic and intrathecal morphine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Age | Factors involving failed spinal anaesthesia for cesarean delivery: patient age | At starting operation | 
| Body mass index | Factors involving failed spinal anaesthesia for cesarean delivery: patient body mass index (BMI) : weight and height will be combined to report BMI in kg/m^2 | At starting operation | 
| Anaesthesiologist performing spinal anaesthesia | Factors involving failed spinal anaesthesia for cesarean delivery: Anaesthesiologist performing spinal anaesthesia (resident or consultant) | At starting anaesthesia | 
| Time starting of operation | Factors involving failed spinal anaesthesia for cesarean delivery: at which time cesarean delivery starting to performed eg. in office hour or out of office hour | At starting operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of failed spinal anaesthesia for cesarean delivery | Incidence of failed spinal anaesthesia for cesarean delivery | At starting operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Spinal anaesthesia, cesarean section