Abstract
ANATOMICAL PREDICTORS OF DIFFICULT SPINAL ANAESTHESIA AMONG WOMEN WHO UNDERWENT CESAREAN SECTION IN A TERTIARY CARE INSTITUTE – A CROSS-SECTIONAL ANALYTICAL STUDY

Kangchai Chaudhuri*, Sankari Roy, Bappaditya Som and Kaushik Tripura

ABSTRACT

Introduction: Spinal anaesthesia is one of the widely used anaesthetic techniques among obstetric patients due to its safety. Despite having high success, there are several instances where anaesthetists have found spinal anaesthesia difficult. Several factors influence the anaesthetic difficulty during the technique. We did this study to determine the anatomical factors influencing difficult spinal anaesthesia among women who underwent cesarean section. Methods: We included a total of 100 pregnant women who underwent spinal anaesthesia during the cesarean section. The women were enrolled consecutively during the study period using specific inclusion and exclusion criteria. Difficult spinal anaesthesia was determined based on the scores developed through various parameters. Adjusted analysis was done to determine the independent factors influencing difficult spinal anaesthesia. Results: All women consented for the study. In multivariable logistic regression analysis, we observed that age group of >35 years, (aOR 1.3 95% CI 1.1 – 1.9), being overweight/obese (aOR 1.7 95% CI 1.2 – 2.3), with previous history of spinal anaesthesia (aOR 1.9 95% CI 1.2 – 2.3), having scoliosis (aOR 1.7 95% CI 1.1 – 2.4), lordosis (aOR 2.9 95% CI 1.7 – 5.3) and kyphosis (aOR 1.8 95% CI 1.2 – 2.7), non-palpable anatomical signs (aOR 1.7 95% CI 1.1 – 3.1) and less narrow non-palpable intervertebral space (aOR 1.9 95% CI 1.2 – 3.8) as independent risk factors for spinal anaesthesia. Conclusion: Our study results highlight the importance of pre anaesthetic determination of anatomical indices among women who undergo C section to predict difficult spinal anaesthesia among them.

Keywords: Caesarean Section, Anatomical Indices, Spinal anesthesia, Anaesthetists.


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