A Retrospective Study to Evaluate the Incidence and Factors Influencing Failed Spinal Anaesthesia in Women Undergoing Caesarean Section

Spinal anaesthesia has emerged as the preferred anaesthesia technique for caesarean sections in last few decades due to lesser number of complications and ease of administration compared to general or epidural anaesthesia.However failed spinal anaesthesia causes a huge physiological & psychological impact on the patient.In this study we aimed at finding the incidence of failed spinal anaesthesia along with the factors that may influence the occurrences of failure in patients undergoing caesarean section.A retrospective analysis was done for all the caesarean sections performed under spinal anaesthesia in our institute from January 2019 to June 2020.Patient & anaesthetic procedure related factors influencing the failure rate were analysed statistically.The incidence of failed spinal anaesthesia was 4.5% of which 0.7 % were documented as total failure & 3.7% as inadequate block.Failure rate was higher in emergency caesarean section, in patients with BMI ≥25 and having active labour pain (p-value <0.05).Spinal injection in lateral position and procedure done by anaesthesia trainee had a statistically significant higher failure rate.A proper positioning of patients in active labour and those with high body mass index along with extra serenity and alertness during emergency procedure is expected to reduce the failure rate.A better understanding and knowledge about the patient and procedure related factors influencing the block height, duration and quality of spinal anaesthesia amongst the trainee would improve the overall success rate.