Complications during spinal anesthesia for cesarean delivery: a clinical report of one year's experience.
OBJECTIVE
To evaluate the incidence and causes of complications associated with spinal anesthesia for cesarean delivery.


METHODS
Prospective study, case series.


METHODS
Tampere University Hospital, 284 patients scheduled for elective or nonelective cesarean delivery with spinal anesthesia. Complications occurring during spinal anesthesia with hyperbaric 0.5% bupivacaine during a 1-year period were analyzed.


RESULTS
Hyperbaric 0.5% bupivacaine for cesarean delivery proved to be a reliable anesthetic with a failure rate of 2.8%. The most common complications were hypotension (42%) and nausea (14%). In 81% of patients, hypotensive periods occurred before delivery. Hypotension before delivery had no correlation with low Apgar scores or with low pH in the umbilical artery of the infant. Risk factors for hypotension were elective procedures and operations without prophylactic ephedrine infusion. Nausea occurred significantly more often if a lower interspace was used for administering the subarachnoid block.


CONCLUSIONS
Spinal anesthesia proved to be a safe, reliable, and rapid method of anesthesia for cesarean delivery, but, in view of a high incidence of minor complications, careful patient monitoring during spinal anesthesia is necessary to make the outcome optimal for mother and fetus.
Juhani
T P
TP
Department of Clinical Sciences, Tampere University, Finland.
Hannele
H
H
D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D002585:Cesarean Section; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000453:epidemiology; D015994:Incidence; D009325:Nausea / Q000139:chemically induced / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies
D002045:Bupivacaine