Assessment of failed spinal anesthesia for cesarean section during COVID-19 pandemic

Abstract

Objective: 1490 pregnant women with confirmed COVID 19 were admitted to the hospital between April 2020 and February 2021. In Ankara City Hospital, Ankara, Turkey, 416 pregnant women gave birth spontaneously and 251 underwent cesarian section. We attempted spinal anesthesia for cesarian sections because all regional anesthesia organizations advised regional anesthesia for obstetric surgery. However, spinal anesthesia for cesarean delivery is not a foolproof method. Material and Method: We used a retrospective analysis of 251 COVID 19 cesarean section anesthesia to determine the incidence of failed spinal anesthesia, management strategies, and risk variables that contribute to failure. Results: The total number of failed spinal anesthesia instances was 14 (5.58%), with 1% of complete failures and 4% of partial failures. One patient was given spinal anesthesia for the 2nd attempt (0.4%), while the other two were given general anesthesia (0.79%). In failed spinal cases, sedation was utilized. Patients received varied dosages of midazolam, fentanyl, ketamine, and propofol. Conclusion: The rate of failed spinal anesthesia among COVID 19 pregnant women was similar to, even lower than, the rate of failed spinal anesthesia in the general population. Despite all the negative consequences, such as wearing PPE and moving around, vision and hearing problems due to PPE, anesthesiologist fear about being infected by the patient or patient anxiety about infection, the future and babies’ health is the reason for this result.