Complications after Spinal Anesthesia for Cesarean Section at Chumphae hospital, Thailand

Abstract

Background : The numbers of patients undergone cesarean section have been increasing over the past decade. Avoiding an issue of difficult airway in general anesthesia, Spinal anesthesia with intrathecal morphine is most common anesthetic technique used for cesarean sections in Thailand. However, side effects and complications from spinal anesthesia were reported in studies. Objective : To study side effects and complications post spinal anesthesia with intrathecal morphine Setting : Chumphae hospital, Khonkean, Thailand Method : A retrospective cohort study was done in 1,300 patients undergone cesarean sections from January 2006 to August 2015 in Chumphae hospital. The retrospective medical record were reviewed for patient demographic factors including sex, age, body weight, height, American Society Of Anesthesiologists (ASA) classification of Physical health, preoperative condition , operative data (type and duration of operation), anesthetic data (total intravenous fluid intake volume, type of vasoactive and sedative agents used, sensory level of spinal blockage) and intra-operative and immediate post-operative complications such as hypotension, shivering, nansea and vomiting. Result : 1,300 pregnant women undergone cesarean section at Chumphae hospital successfully received spinal anesthesia from January 2006 to August 2015. Hypotension was observed in 69.9% of women. Other observable complications were shivering (7.13%), nauseate (6.46%), vomiting (6.77), and pruritus (6.15%). High block was found in one pregnant women. No incidence of backache and respiratory distress were observe. Conclusion : The most common complication was hypotension. The others were shivering, nauseate and vomiting. Further studies should try intervention such as co-load fluid 10 ml/kg to prevent hypotension.