The practice of spinal anaesthesia in two tertiary hospitals in South-East Nigeria - review of 100 cases

Abstract

Background: Spinal anaesthesia is very important as it avoids the numerous complications that could arise from general anaesthesia including airway problems. It is cost effective and can be used for surgeries of up to two hours duration.
Objectives: To evaluate the practice of spinal anaesthesia in South-East Nigeria and document the intraoperative complications as was observed in our centre.
Methodology: The study is a prospective multi-centre study carried out at the University of Nigeria Teaching Hospital (UNTH) Enugu and the National Orthopaedic Hospital Enugu (NOHE). Patients who were scheduled for surgery under spinal anaesthesia were recruited into the study. Demographic data, type of operation done, American Society of Anesthesiologists (ASA) physical status classification and intra-operative complications were recorded using a proforma. Also, recorded were the size and type of spinal needle and site of injection of local anaesthetics.
Results: A total of 100 patients who met the inclusion criteria were simultaneously recruited into the study. They were between the ages of 18 and 75years with a mean age of 40.2 ± 14.5years. They were 50 males and 50 females. The mean weight was 76.0 ± 13kg and the height was 168 ±11.7cm. The mean duration of surgery was 83.3 ± 26.3minutes. Most of the operations done were orthopaedic surgery 46%. The most common intra-operative complication was hypotension with an incidence of 28%, followed by shivering 21%. Other intra-operative complications included pain 9%, nausea 3%, respiratory difficulty 2%, bradycardia 1% and failed spinal anaesthesia 1%. The hypotension observed during caesarean section was significantly higher than in orthopaedic patients (X2=4.060, p = 0.044).
Conclusion: In this series no mortality or permanent morbidity was recorded. The practice of spinal anaesthesia is safe.

Keywords: Caesarian section, hypotension, intra-operative complication, orthopaedic surgery, safe anaesthesia