Assessment of block height for satisfactory spinal anaesthesia for caesarean section in Kenyatta national hospital
Abstract
Background
Spinal anaesthesia (SA) is the most common anaesthetic technique in use for the
facilitation of caesarean delivery, both locally as well as internationally due to its various
advantages over
alternative methods. Confirmation of the level of spinal block prior to
beginning the surgery is mandatory, to ensure adequate block for maximal patient
comfort intraoperatively. It also gives the anaesthesia practitioner an indication of spread
of spinal
block higher than intended, allowing early intervention and avoidance of
complications.
Objective
To assess and record the level and density of sensory and motor block being achieved by
spinal anaesthesia for caesarean delivery in Kenyatta National Hospital.
Methodology
After obtaining informed consent from patients planned for caesarean section, spinal
anaesthesia was
administered as per the current protocol in Kenyatta National Hospital
(KNH) maternity theatre. The patient was
then positioned on the operating table. The
different sensory modalities and motor block assessments were performed sequentially on
each side and the highest dermatomal level reported by the patient was recorded on a
chart. The assessment was performed 2
minutes after drug administration, with a repeat
assessment after 5 minutes
and 8 minutes, before surgery was begun.
Any intraoperative event, rescue analgesia administered or change in anaesthetic
technique was recorded.
Publisher
University of Nairobi