Spinal block complications in obstetrics and gynecology patients

OBJECTIVE: To determine spinal complications during and after surgery in obstetrics and gynecological patients.

METHODS: We conducted a descriptive study in Al-Wahda and Aden Teaching Hospitals in Aden, Yemen from March 2004 to March 2005. One hundred and fifty obstetrics and gynecological patients were enrolled. Before and during surgery, pulse and blood pressure was monitored, and patients were observed for any complications of spinal anesthesia, for example, hypotension, nausea, vomiting, shivering, and total spinal block. Post operatively, the patients were followed to identify post-spinal headache, urine retention, neuralgia, back pain, and respiratory failure. Results of complications were related by applying statistical test.

RESULTS: Hypotension during surgery was established at a very high percentage of 82%. This could be due to lack of preloading of the patients before spinal block. Vomiting was 61%, nausea 56%, shivering 30%, and total spinal anesthesia 2%. Post operatively, 77.3% patients had post spinal headache, which lasted 4 days, compared with patients who had been applied with non-cutting disposable needles. Urine retention was 38.7%, while back pain and neuralgia was 21.3% each, and respiratory failure was 1.3%.

CONCLUSION: Hypotension was traced in a very high percentage of cases due to unawareness and ignorance of pre-anesthetic intravenous fluid loading by concerned staff. Post spinal headache was the second most common complication due to the usage of large, cutting, non-disposable needles.