Continuous spinal anaesthesia: A retrospective analysis of 318 cases
Background and Aims: Continuous spinal anaesthesia (CSA) is an underutilised anaesthetic technique. Our objectives were to evaluate the use of CSA in our institution, its efficacy, ease to use and safety. Methods: This was a retrospective analysis conducted in a tertiary centre. Records of all patie...
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| Format: | Article |
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Medknow Publications
2018
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| author | Beh, Zhi Yuen Yong, Phui Sze Au Lye, Siyu Eapen, Sneha Elizabeth Yoong, Chee Seng Woon, Kwee Lian Lim, Jimmy Guan Cheng |
| author_facet | Beh, Zhi Yuen Yong, Phui Sze Au Lye, Siyu Eapen, Sneha Elizabeth Yoong, Chee Seng Woon, Kwee Lian Lim, Jimmy Guan Cheng |
| author_sort | Beh, Zhi Yuen |
| collection | UM |
| description | Background and Aims: Continuous spinal anaesthesia (CSA) is an underutilised anaesthetic technique. Our objectives were to evaluate the use of CSA in our institution, its efficacy, ease to use and safety. Methods: This was a retrospective analysis conducted in a tertiary centre. Records of all patients who underwent surgery and received CSA between December 2008 and July 2017 were reviewed. Their demographic profiles, type and duration of surgery were analysed. The outcomes measured were the success of CSA, technical evaluation and difficulties encountered, intraoperative haemodynamics, usage of vasopressors and any reported complications. Statistical analysis was done using Chi-square test. Results: Three hundred and eighteen patients (94%) successfully underwent surgery using CSA. Twenty cases (6%) had failed CSA, of which five of them had CSA insertion failure, while the rest failed to complete the operation under CSA, thus requiring conversion to general anaesthesia. Patients who have had an initial intrathecal local anaesthetic (LA) volume ≥1.5 ml had higher odds (odds ratio (OR) 2.78; 95% confidence interval [CI], 1.70–4.57) of developing hypotension compared to those who had <1.5 ml (P < 0.001). There were no reported post-dural puncture headache, neurological sequelae or infection. Conclusion: CSA is a useful anaesthetic technique with low failure rate. The key to achieving haemodynamic stability is by giving a small initial bolus, then titrating the block up to required height using aliquots of 0.5 ml of intrathecal LA through the catheter. |
| first_indexed | 2024-03-06T05:56:38Z |
| format | Article |
| id | um.eprints-22326 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:56:38Z |
| publishDate | 2018 |
| publisher | Medknow Publications |
| record_format | dspace |
| spelling | um.eprints-223262019-09-13T03:11:21Z http://eprints.um.edu.my/22326/ Continuous spinal anaesthesia: A retrospective analysis of 318 cases Beh, Zhi Yuen Yong, Phui Sze Au Lye, Siyu Eapen, Sneha Elizabeth Yoong, Chee Seng Woon, Kwee Lian Lim, Jimmy Guan Cheng R Medicine Background and Aims: Continuous spinal anaesthesia (CSA) is an underutilised anaesthetic technique. Our objectives were to evaluate the use of CSA in our institution, its efficacy, ease to use and safety. Methods: This was a retrospective analysis conducted in a tertiary centre. Records of all patients who underwent surgery and received CSA between December 2008 and July 2017 were reviewed. Their demographic profiles, type and duration of surgery were analysed. The outcomes measured were the success of CSA, technical evaluation and difficulties encountered, intraoperative haemodynamics, usage of vasopressors and any reported complications. Statistical analysis was done using Chi-square test. Results: Three hundred and eighteen patients (94%) successfully underwent surgery using CSA. Twenty cases (6%) had failed CSA, of which five of them had CSA insertion failure, while the rest failed to complete the operation under CSA, thus requiring conversion to general anaesthesia. Patients who have had an initial intrathecal local anaesthetic (LA) volume ≥1.5 ml had higher odds (odds ratio (OR) 2.78; 95% confidence interval [CI], 1.70–4.57) of developing hypotension compared to those who had <1.5 ml (P < 0.001). There were no reported post-dural puncture headache, neurological sequelae or infection. Conclusion: CSA is a useful anaesthetic technique with low failure rate. The key to achieving haemodynamic stability is by giving a small initial bolus, then titrating the block up to required height using aliquots of 0.5 ml of intrathecal LA through the catheter. Medknow Publications 2018 Article PeerReviewed Beh, Zhi Yuen and Yong, Phui Sze Au and Lye, Siyu and Eapen, Sneha Elizabeth and Yoong, Chee Seng and Woon, Kwee Lian and Lim, Jimmy Guan Cheng (2018) Continuous spinal anaesthesia: A retrospective analysis of 318 cases. Indian Journal of Anaesthesia, 62 (10). pp. 765-772. ISSN 0019-5049, DOI https://doi.org/10.4103/ija.IJA_387_18 <https://doi.org/10.4103/ija.IJA_387_18>. http://europepmc.org/articles/PMC6190429;jsessionid=6E260E06B2FDF69CB88EFC15B0E9AA12 doi:10.4103/ija.IJA_387_18 |
| spellingShingle | R Medicine Beh, Zhi Yuen Yong, Phui Sze Au Lye, Siyu Eapen, Sneha Elizabeth Yoong, Chee Seng Woon, Kwee Lian Lim, Jimmy Guan Cheng Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title | Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title_full | Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title_fullStr | Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title_full_unstemmed | Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title_short | Continuous spinal anaesthesia: A retrospective analysis of 318 cases |
| title_sort | continuous spinal anaesthesia a retrospective analysis of 318 cases |
| topic | R Medicine |
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