The Failed Spinal Explained
block education obstetrics anaesthesia patient safety spinal Sep 26, 2023Spinal anaesthesia for obstetric patients has a failure rate of about 1-5% 🤯
Spinals usually fail in 3 ways: 🆘
👉 no block at all
👉 block not high enough
👉 block wears off too early
It is standard practice to check the block with ice before starting the procedure, and a block to ice at T6 is the goal. Regardless of the block height, if the patient is feeling pain it should be addressed promptly! 🧊🧊
When a spinal fails, you have 3 options (3 R’s):
1️⃣ Repeat:
If you haven’t started the surgery yet, the anaesthetist might have another attempt. They may alter the dose the for second attempt to avoid a high block.
2️⃣ Revive
If you haven’t started the surgery yet you may be able to increase the height of the block by positioning the patient slightly head down and waiting another 10 mins.
3️⃣ Recourse
If the surgery has started, you may need to convert to a GA. Occasionally, if the baby has been delivered, some IV analgesia might also be appropriate.
Have a look at our Concept Series blog on GA Caesar for more information! 😎
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