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Year : 2018  |  Volume : 62  |  Issue : 9  |  Page : 691-697

Approach to failed spinal anaesthesia for caesarean section

1 Department of Anesthesia, Breach Candy Hospital; Department of Anesthesia, Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India
2 Department of Anesthesia, Janani Anesthesia and Critical Care Services, Shimoga, Karnataka, India

Correspondence Address:
Dr. Ketan S Parikh
15, Asha Mahal, 46-B, Pedder Road, Mumbai - 400 026, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ija.IJA_457_18

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Failure of spinal anaesthesia for caesarean section may have deleterious consequences for the mother as well as the newborn baby. In this article, we discuss the mechanisms of failure of spinal anaesthesia as well as the approach to a failed block. We performed a literature search in Google Scholar, PubMed, and Cochrane databases for original and review articles concerning failed spinal anaesthesia and caesarean section. Strategies for a failed spinal anaesthetic include manoeuvers to salvage the block, repeating the block, epidural anaesthesia or a combined spinal–epidural (CSE) technique, or resorting to general anaesthesia. Factors influencing the choice of these alternative options are discussed. A “failed spinal algorithm” can guide the anaesthesiologist and help reduce morbidity and mortality.

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