A case report of complete spinal anesthesia in cesarean section

Document Type : Case report

Authors

1 Associate Professor, Department of Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

2 Assistant professor, Department of Obstetrics and Gynecology, Women's Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

3 Instructor, Department of Anesthesiology, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

Abstract

Introduction: Complete intraspinal anesthesia is a rare but life-threatening complication and is characterized by decreased level of consciousness, drop in blood pressure, bradycardia and respiratory failure. The present study reported a case of complete spinal anesthesia in caesarean section surgery.
Case Presentation: The patient, a 33-year-old woman with gravid 2, referred to Motahari Hospital in Jahrom city for a cesarean section. Spinal anesthesia was performed in a sitting position with a spinal needle size 25and with the first attempt at the L3-L4 level, and then the patient was placed in the supine position and with a brief Trendelenburg position, the level of anesthesia was increased to T4, and after ensuring the sensory block and Motor (T8), the patient's bed was placed in a flat state without position. The patient's blood pressure 3 minutes after spinal anesthesia was 103.72 mmHg and heart rate was 84 times per minute. At this moment and before making the surgical incision, suddenly the patient's level of consciousness dropped drastically; so that she did not respond to verbal commands and breathing stopped completely and respiratory apnea occurred and the patient's saturation decreased to about 78%, but the patient's blood pressure and heart rate did not decrease significantly. Immediately and without delay and without giving any anesthetic, the patient was intubated with a size 7 tracheal tube and connected to the anesthesia machine and saturation reached 98%. The operation started and the baby was born with fifth minute Apgar score of 9 and the patient woke up completely at the end of the operation and was extubated and transferred to recovery without any special complications.
Conclusion: The present study adds a special and uncommon case of complications of spinal anesthesia to the previously reported limited cases and shows the clinical characteristics and appropriate treatment performance in the face of complete spinal anesthesia during cesarean section. Therefore, by knowing the effective factors in reducing this complication, an effective step can be taken to reduce it as much as possible.

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 5
July 2024
Pages 71-76

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