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High spinal block after failed epidural anesthesia in cesarean section due to non-progression of labor.

Authors

  • Diego Gutiérrez Martínez Hospital Universitario Puerta de Hierro
  • Alberto Gutiérrez Martínez Specialist Anesthesiology and Resuscitation Service at Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
  • Verónica Guilló Moreno Specialist Anesthesiology and Resuscitation Service at Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
  • Javier García Fernández Head of the Anesthesiology and Resuscitation Service at the Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.

DOI:

https://doi.org/10.30445/rear.v14i11.1125

Keywords:

failed epidural anesthesia, High spinal block, spinal anesthesia, incomplete epidural block

Abstract

High spinal block is one of the most serious complications that can occur during neuraxial anesthesia for cesarean section. One of its causes is the rescue of a failed epidural anesthesia by intradural anesthesia. It can lead to serious hemodynamic and respiratory complications, so early recognition and treatment is essential to improve the prognosis. To avoid a high spinal block when using rescue spinal anesthesia after administering a bolus of epidural anesthesia, wait 30 minutes, reduce the spinal dose, and maintain the sitting position for 2 minutes. In urgent cases, general anesthesia is recommended.

References

- Portnoy D, Vadhera RB. Mechanisms and management of an incomplete epidural block for cesarean section. Anesthesiology Clinics of North America. 2003;21(1):39–57.

- Bauer M, Kountanis J, Tsen L, Greenfield M, Mhyre J. Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials. International Journal of Obstetric Anesthesia. 2012;21(4):294–309.

- Blumgart C, Ryall D, Dennison B, Thompson-Hill L. Mechanism Of Extension Of Spinal Anaesthesia By Extradural Injection Of Local Anaesthetic. British Journal of Anaesthesia. 1992;69(5):457–60.

- Dadarkar P, Philip J, Weidner C, Perez B, Slaymaker E, Tabaczewska L, et al. Spinal anesthesia for cesarean section following inadequate labor epidural analgesia: a retrospective audit. International Journal of Obstetric Anesthesia. 2004;13(4):239–43.

- Vaida S, Cattano D, Hurwitz D, Mets B. Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia. F1000Research. 2015;4:98.

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Published

2022-12-05

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How to Cite

Gutiérrez Martínez, D., Gutiérrez Martínez, A., Guilló Moreno, V., & García Fernández, J. (2022). High spinal block after failed epidural anesthesia in cesarean section due to non-progression of labor. Revista Electrónica AnestesiaR, 14(11). https://doi.org/10.30445/rear.v14i11.1125

Issue

Vol. 14 No. 11 (2022): Revista Electrónica de AnestesiaR

Section

Clinical case reports

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