Complications of Spinal Anaesthesia
Oct 23, 2023A 25yo woman starts feeling faint and nauseated 5 minutes after administration of spinal anaesthesia for caesarean section. 🤰🏽 🤢
What’s going on? 🤔
Let’s go back a step, what is a spinal anaesthetic? 💉
A “spinal” is an injection of local anaesthetic (+/- opioid) in the fluid surrounding the spinal cord (the CSF). It provides dense motor and sensory block within minutes, and lasts around 2 hours. 🤗
At the same time as blocking the sensation and motor function, it also blocks the nerves that cause vasoconstriction. 🫤
The complications can be thought of as early and late. ⏱️👀
Early:
👉🏻 Low BP, Low HR
👉🏻 Nausea & vomiting
👉🏻 Effects of high/total spinal (see our post on high spinal)
👉🏻 Shivering
👉🏻 Itch
👉🏻 Transient hearing loss
👉🏻 Urinary retention
Late:
👉🏻 Headache (dural puncture) ~ 1%
👉🏻 Nerve damage (from direct needle trauma, infection or haematoma) ~ 1/10,000 - 1/200,000
👉🏻 Nerve disorders relating to drug error
As the anaesthetic nurse, you will often see hypotension and nausea. Management is with IV fluids and drugs that increase blood pressure! 🙌🏻
Build knowledge ✅
Improve safety ✅
Ref: https://www.nysora.com/techniques/neuraxial-and-perineuraxial-techniques/spinal-anesthesia/