Complication Of Spinal Anesthesia Research Articles

Comparison of clinical efficacy of hyperbaric ropivacaine with hyperbaric bupivacaine in spinal anesthesia for transurethral resection of prostate: A randomized and double-blind study

Background: Ropivacaine is an ammino-amide local anesthetic agent with properties similar to bupivacaine, but its decreased lipophilicity is associated with reduced incidence of central nervous system toxicity and cardiotoxicity. This study evaluated the safety, efficacy, effects on hemodynamics and complications of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing transurethral resection of the prostate (TURP). Aims and Objectives: The aim was to evaluate the safety, efficacy, hemodynamic stability, and side effects of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing TURP. Materials and Methods: Sixty adult patients with physical status classes I and II, as determined by the American Society of Anesthesiologists, scheduled to undergo elective transurethral resection of prostate, were randomly allocated to receive either hyperbaric ropivacaine 0.75% 2.8 mL plus fentanyl 15 mcg or hyperbaric bupivacaine 0.5% 2.8 mL plus fentanyl 15 mcg. The parameters, such as demographic characteristics, duration of surgery, onset of sensory and motor blockade, hemodynamic stability, and complications, were compared in both groups. Results: Hyperbaric ropivacaine exhibited significantly slower onset times for sensory and motor blockade compared to hyperbaric bupivacaine. Patients in the ropivacaine group demonstrated better hemodynamic stability and experienced less hypotension compared to those who received bupivacaine. Moreover, the sensory and motor block lasted significantly longer in the bupivacaine group. Conclusion: About 0.75% hyperbaric ropivacaine is a better choice for spinal anesthesia in elderly patients undergoing TURP as compared to 0.5% hyperbaric bupivacaine.

Subarachnoid Hemorrhage Following Spinal Anesthesia: Two Case Reports

Spinal anesthesia has been performed on patients who undergo cesarean section, for years. A variety of complications are reported which are followed by spinal anesthesia; but subarachnoid hemorrhage is not one of them. In this study, we present two cases of Subarachnoid hemorrhage resulting from spinal anesthesia. In both cases, patients suffered from a thunderclap sudden-onset headache after undergoing cesarean section. Imaging and laboratory investigations were performed in order to determine the reason contributing to the headache, which revealed subarachnoid hemorrhage. After investigation and excluding other underlying causes, normal imaging studies suggested that the occurrence of subarachnoid hemorrhage as a possible complication of spinal anesthesia should be considered.

Safety of spinal anesthesia and analysis of cerebrospinal fluid in SARS-CoV-2 pregnant women undergoing cesarean section: an observational prospective study

BackgroundSystemic infection has always been considered a relative contraindication to neuraxial anesthesia, despite the fact that infectious complications are relatively uncommon. Pregnancy-related physiological changes and coronavirus disease (COVID-19) neurotropic features may facilitate the virus’ entry into the central nervous system. The principal aim of this study was to test the safety of spinal anesthesia in “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2)-positive pregnant women and to examine cerebrospinal fluid (CSF) characteristics.MethodsWe conducted a prospective observational single-center study in asymptomatic or paucisymptomatic consecutive pregnant SARS-CoV-2 patients who underwent spinal anesthesia for cesarean section. Women with severe infection were excluded because they underwent general anesthesia. At the time of spinal anesthesia, we collected CSF samples, and then we performed a chemical-physical analysis to look for signs of inflammation and for SARS-CoV-2 genome.ResultsWe included 26 women. No spinal anesthesia complications were reported in the perioperative period and after 2 months. All CSF samples were crystal clear, and all physical-chemical values were within physiological ranges: the median concentration of CSF/plasma glucose ratio was 0.66, IQR 0.5500 (0.6000–0.7100), and the average CSF protein concentration value was 23.2 mg/dl (SD 4.87). In all samples, genomes of SARS-CoV-2 and other neurotropic viruses were not detected.ConclusionsSpinal anesthesia was safe in SARS-CoV-2 pregnant women with mild disease; no clinical maternal complications were detected, and no CSF changes indicative of inflammatory or infectious diseases that would compromise the safety of the procedure were found.

An evaluation of spinal anesthesia results in pediatric patients undergoing pilonidal sinus surgery: a retrospective study

Aims: The aim of this retrospective study was to evaluate the efficacy, side-effects, and complications of spinal anesthesia (SpA) in children undergoing pilonidal sinus surgery with SpA.
 Methods: The records of pediatric patients who underwent pilonidal sinus surgery with SpA from January 2019 to March 2023 were retrospectively evaluated from the database in the Samsun University Samsun Maternity & Children's Training and Research Hospital, Department of Anesthesiology and Reanimation, Türkiye. Children's sociodemographic characteristics, clinical and vital signs, motor block duration, operative time, and complications were recorded.
 Results: Eighty-one patients underwent pilonidal sinus surgery with SpA, 54 (66.7%) boys and 27 (33.3%) girls, with a mean age of 14.38±1.29 years. The patients’ mean body mass index was 26.83±1.1 kg.m-2, and the success rate was 96.3% (n=78). Eleven (13.6%) patients received supplemental anesthesia among the 78 procedures completed using SpA. The incidence of complications was 5.1% (n=4). Intraoperative hypotension developed in two cases and postoperative vomiting in two, all of which resolved with no sequelae.
 Conclusion: Our retrospective analysis suggests that pediatric SpA is a safe and effective technique for children undergoing pilonidal sinus surgery. However, further prospective studies are warranted to confirm these findings.

Addition of Neostigmine and Atropine to Conventional Management of Postdural Puncture Headache in Patients Undergoing Lower Abdominal Surgeries

Abstract Background Postdural puncture headache (PDPH) is a complication of spinal anesthesia or lumbar puncture and is an unpleasant experience for the patient as well as the anesthetist. It is thought to result from meningeal traction related to low cerebrospinal fluid (CSF) pressure or cerebral vasodilation as an indirect effect of decreased CSF pressure. Neostigmine is a reversible inhibitor of the enzyme cholinesterase, which results in an increased concentration of the neurotransmitter acetylcholine. It produces cholinergic-mediated analgesia and has been used as an adjunct analgesic postoperatively. Neostigmine can pass through the choroid plexus but not the blood–brain barrier, the central effect of both neostigmine and atropine influence both CSF secretion and cerebral vascular tone which are the primary pathophysiological changes in PDPH. Objective Assess the effectiveness of postdural anesthesia with addition of Neostigmine and Atropine versus conventional postdural anesthesia. Patients and Methods A 90 patients were included in our prospective randomized controlled double-blind study that was conducted at Ain Shams University Hospitals for 4 months on patients who fulfilled the inclusion criteria: patients with ASA Grade I & II, aged from (18 to 40) years old and scheduled for cesarean section. All patients aged >18 or <40, body weight >50, ASA III, IV, patients with uncontrolled chronic diseases such as hypertension, cardiac, renal, hepatic, cerebral diseases and peripheral vascular diseases, patients with history of PDPH, chronic headache, cluster headache, migraine, convulsions, cerebrovascular accident, signs of meningismus, preeclampsia, eclampsia coagulopathy, and previous neurological diseases and patients with history of bronchial asthma were excluded. Patients were divided into 2 groups: Group I (experimental group): neostigmine and atropine and Group II (placebo group): Saline placebo. Results The results of this study showed that incidence of postoperative headache was significantly lower among the intervention group, furthermore, VAS was significantly lower in the experimental arm versus placebo one. However, there was no significant difference regarding demographic, vital signs, and need for post-operative analgesia. The presented study showed that there is statistically non-significant difference between the studied groups regarding age, weight, and height and body mass index. There is statistically non-significant difference between the studied groups regarding duration of surgery. Conclusion After demonstrating many management options for post dural puncture headache (PDPH), in this study, we tried to prove the value of the use of neostigmine as a new management option that looks promising to alleviate the symptoms of such distressing condition. The current study results proved that the drug reduced the number of cases that experienced (PDPH) after spinal anesthesia for lower segment caesarean section, and how it prevent &control headache. A combination of neostigmine and atropine are effective in managing PDPH by reducing the associated VAS score and preventing persistence of headache.

The relationship between abdominal circumference-to-hip ratio and ephedrine requirement in spinal anesthesia for elective cesarean: A prospective observational study Running title: AC-to-hip ratio and ephedrine requirement

Objective: Maternal hypotension caused by extensive sympathetic blockade is a serious complication of spinal anesthesia during cesarean section. This study planned to determine the relationship between weight, height, BMI, abdominal circumference (AC), hip circumference (HC), and AC-to-hip ratio with the ephedrine consumption in patients who underwent cesarean section with subarachnoid block. Materials and Methods: The study population comprised 60 women. Prior to spinal anesthesia; patients' demographic characteristics (age, weight, height), abdominal and hip circumferences, basal hemodynamic parameters, and ASA physical status were recorded. To minimize errors, three consecutive measurements were obtained; results were averaged and the AC-to-hip ratio was calculated by dividing the values of the abdominal (cm) and hip circumference (cm). In all patients, spinal anesthesia was done in the sitting position using 2.4 ml 0.5% hyperbaric bupivacaine (12 mg). Persistent hypotension was treated with intravenous ephedrine (5 mg). The number of patients who used ephedrine and the total amount of ephedrine used during surgery were recorded. Results: Of these 60 participants, 40 (66.6%) patients had hypotension requiring ephedrine administration. There is a positive correlation between ephedrine consumption (mg) and abdominal circumferences (r=0.280, p=0.03). Also, there is a significant positive correlation between ephedrine consumption (mg) and AC-to-hip ratio (r=0.608, p<0.001). The correlation coefficient between the ephedrine dose with the AC-to-hip ratio was 56.805, the p-value was <0.001 and AC was 0.211, with a p-value of 0.030 which means the correlation was statistically significant. Conclusion: Abdominal circumference and AC-to-hip ratio have a significant correlation with ephedrine consumption in patients who underwent cesarean section via subarachnoid block with a given dose of 2.4 ml 0.5% hyperbaric bupivacaine.

RELATIONSHIP OF LONG OPERATION WITH SHIVERING EVENTS IN POST SPINAL ANESTHETIC PATIENT AT RSUD LEUWILIANG BOGOR REGENCY

Shivering is a complication of spinal anesthesia with an incidence of up to 33-57%. The long duration of surgery causes the anesthetic procedure to be longer. This will increase the time of exposure of the body to cold temperatures and cause the effect of accumulating drugs and anesthetic agents. Data on surgical patients at Leuwiliang Regional Hospital from December 2021 to February 2021, namely 60% of patients underwent surgery <1 hour, 20% underwent 1-2 hours of surgery, and 20% underwent >2 hours of surgery. The incidence of shivering at Leuwiliang Regional Hospital is 5 out of 10 patients (50%). The study aimed to determine the relationship between the duration of surgery and the incidence of shivering in patients after spinal anesthesia at Leuwiliang Hospital, Bogor Regency. The research method uses a type of analytics that is cross-sectional. The population in this study was 1212 respondents. The sampling technique in this study used purposive sampling techniques for 92 respondents.The data was taken by making observations to respondents. The results showed that the duration of the operation was 1-2 hours as many as 51 respondents (55.4%). The incidence of shivering in patients after spinal anesthesia found that there was a degree 3 shivering of 54 respondents (58.7%). There is a long association of surgery with the incidence of shivering in post-spinal anesthesia patients with a p-value of 0.001 (P<0.05). To Leuwiliang Hospital, especially for anesthesiologists, to increase vigilance against post-anesthesia shivering events to prevent complications after spinal anesthesia

The complications of spinal anesthesia after cesarean section in women with Covid-19: a case-control study

The complications of spinal anesthesia after cesarean section in women with Covid-19: a case-control study

Pneumocephalus as a complication of spinal anesthesia in a child

Pneumocephalus as a complication of spinal anesthesia in a child

Troubleshooting obstetric spinal anaesthesia at district hospital level.

Obstetric spinal anaesthesia is routinely used in South African district hospitals for caesarean sections, providing better maternal and neonatal outcomes than general anaesthesia in appropriate patients. However, practitioners providing anaesthesia in this context are usually generalists who practise anaesthesia infrequently and may be unfamiliar with dealing with complications of spinal anaesthesia or with conversion from spinal to general anaesthesia. This is compounded by challenges with infrastructure, shortages of equipment and sundries and a lack of context-sensitive guidelines and support from specialised anaesthetic services for district hospitals. This continuous professional development (CPD) article aims to provide guidance with respect to several key areas related to obstetric spinal anaesthesia, and to address common concerns and queries. We stress that good clinical practice is essential to avoid predictable, common complications, and hence a thorough preoperative preparation is essential. We further discuss clinical indications for preoperative blood testing, spinal needle choice, the use of isobaric bupivacaine, spinal hypotension, failed or partial spinal block and pain during the caesarean section. Where possible, relevant local and international guidelines are referenced for further reading and guidance, and a link to a presentation of this topic is provided.

Advantages of spinal anesthesia in orthopedic surgery

Introduction. Spinal anesthesia is one of the oldest and most commonly used regional anesthesia techniques. It is based on the injection of a local anesthetic into the subarachnoid space, during which there is a transient interruption of impulse conduction in the spinal nerve roots. Application of spinal anesthesia. The use of spinal anesthesia depends on the following factors: the site of the surgical procedure, the type and duration of the surgical procedure, the degree of necessary surgical relaxation, and presence of accompanying diseases. Local anesthetics used in spinal anesthesia. There are two types local anesthetics used in spinal anesthesia. These are local anesthetics of the ester and amide type. Most frequently applied local anesthetics are those of the amide type. Orthopedic procedures under spinal anesthesia. The most common surgical procedures in orthopedic surgery performed under spinal anesthesia are hip, knee and ankle surgeries. Complications of spinal anesthesia. The most common complications of spinal anesthesia are hypotension, bradycardia, urinary retention, and postpuncture headache. Conclusion. The advantages of spinal over general anesthesia in orthopedic surgery include lower incidence of respiratory and myocardial depression, better peripheral tissue perfusion, minimal coagulation system disorders and prolonged postoperative analgesia.

Chronic intracranial subdural hematoma after spinal anesthesia for a cesarean section: a case report

BackgroundSubdural hematoma is a rare, potentially devastating, yet curable complication of spinal anesthesia. Differentiation between post-dural puncture headache and subdural hematoma can be difficult, resulting in a delay in diagnosis.Case presentationWe present a 28-year-old Ethiopian female patient who underwent elective cesarean section under spinal anesthesia and returned to the emergency department after 1 month with a worsening headache. Brain computed tomography revealed a chronic subdural hematoma with a significant midline shift. The patient recovered completely after surgical evacuation.ConclusionsA high index of suspicion and close attention to the pattern and characteristics of the headache, coupled with a meticulous neurologic examination and neuroimaging, can help to achieve timely diagnosis of this serious entity. Investigation with head computed tomography or magnetic resonance imaging is vital.

A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia

Introduction: Spinal anesthesia has offered a new armamentarium for the anesthesiologists and has been widely used in the Cesarean section in the field of obstetrics, an alternative to general anesthesia. However, Post Dural Puncture Headache remains an inevitable complication of spinal anesthesia and can be minimized its incidence by reducing the size of the needle and changing the design of the needle tip. The objective of the study was to find the incidence of post-dural puncture headache undergoing subarachnoid block for CS using 25G Quincke and 25G Whitacre needles.
 Materials and methods: This study was conducted from August 2020 to January 2021 enrolling 72 parturients and were allocated in two groups of 36 each. Group A and B parturients received spinal anesthesia via. 25G Quincke and 25G Whitacre in sitting position respectively. All the patients were evaluated based on incidence, onset, duration, and severity of headache postoperatively for 72 hours after the subarachnoid block.
 Results: The incidence of post-dural puncture headache in the study was 7.2% in Group A and 3.15% in Group B which was statistically significant (P-value = 0.011), while there were no significant differences between these two groups in the onset, severity, and duration of post-dural puncture headache.
 Conclusion: Despite no significant differences were found for the onset, severity, and duration of post-dural puncture headache, the use of 25G Whitacre is associated with a reduced incidence of post-dural puncture headache compare to 25G Quincke.

Post Dural Puncture Headache After Elective Caesarean Section Using 27 G Quincke and Whitacre Spinal Needles: A Comparative Study

INTRODUCTION
 Post-dural puncture headache (PDPH), a serious complication of spinal anesthesia (SA) may persevere for long time and can be unbearable to the patients. The incidence of PDPH unswervingly relies on the size of the spinal needles used and this gradually decreases with the use of thinner spinal needles.
 
 MATERIAL AND METHODS
 A prospective randomized single blinded study was conducted during the period between 1 to 29 January 2019, at Universal College of Medical Sciences, Nepal. A total of 120 patients (between 20-35 years of age) were divided into two groups: Group I: 60 patients given SA with 27-G Quincke needle and Group II: 60 patients given SA with 27-G Whitacre. Randomization was done by coin tossing method and double-blinded except for the anesthetist performing the spinal block. Patients were interviewed on days 1 to 5 and were questioned with regard to headache based on its severity, location, character, duration, associated symptoms (nausea, vomiting, auditory and ocular symptoms). The severity of the headache was analyzed by Crocker scale.
 
 RESULTS
 The results showed that 33% more headache in group A, but the t-value was 0.727 and p-value was 0.2345 which was statistically insignificant.
 
 CONCLUSION
 Hence, using 27-G Quincke spinal needles does appear to be advantageous to the patients whereas, Whitacre spinal needles are shown to be clearly associated with fewer cases of PDPH.

P.156 Fractured spinal needle: a rare, but potentially dangerous, complication of spinal anaesthesia

Introduction: Fractured spinal needles are a rare, but documented, complication of attempted spinal anaesthesia. 1 Kaboré RAF, Traore IA, Traore SIS, et al. Broken needle during spinal anesthesia: an avoidable complication. Local Reg Anesth 2018; 11: 111-3. Google Scholar , 2 Yazdanyar N, Nielsen YW. Needle fracture-a rare complication to spinal anaesthesia. Eurorad 2013; 10885. https://www.eurorad.org/case/10885 Google Scholar Both the incidence and clinical significance of a retained spinal needle fragment are unknown.

Preprocedural Ultrasonography Versus Landmark-Guided Spinal Anesthesia in Geriatric Patients with Difficult Anatomy: A Prospective Randomized Trial.

This study was aimed to determine whether preprocedural ultrasonography (USG) affects the technical performance of spinal anesthesia in elderly patients with difficulty in palpating landmarks, scoliosis, or previous spine surgery. This prospective study was conducted in 156 elderly patients scheduled for elective orthopedic lower extremity surgery. The patients were randomly divided into 2 groups to receive spinal anesthesia by the preprocedural USG examination (group U) or conventional landmark palpation technique (group P). The primary finding of our study was the rate of successful access to the subarachnoid space on initial needle insertion attempt. Secondary achievements included number of needle insertion attempts, number of needle redirections, total procedure time, needle pain scores, patient satisfaction, and complications of spinal anesthesia. The rate of successful access to the subarachnoid space at the first needle insertion attempt was significantly higher in group U than in group P (74.4% vs 53.8%, p=0.008). Medians (interquartile range) of both needle insertion attempts (group P, 2 [1-3] vs group U, 1 [1-2]; p=0.038) and needle redirections (group P, 3 [2-5] vs group U, 2 [1-4]; p=0.028), requiring to achieve dural puncture, were significantly higher among the patients in group P than those in group U. No statistically significant difference was found between the groups regarding total procedure time, pain scores, patient satisfaction scores, and spinal anesthesia-induced complications (p>0.05). Our study findings showed that preprocedural neuroaxial USG improves technical performance of spinal anesthesia in elderly patients with difficult anatomy.

Comparative study of postdural puncture headache in midline and paramedian approach of spinal anaesthesia at a tertiary hospital

Background: Postdural puncture headache (PDPH) is a known complication of spinal anaesthesia. It is an iatrogenic cause,results after either intentional or accidental dural puncture.It begins typically within 2 days but regresses spontaneously in a few days. Present comparative study was conducted in patients who underwent elective lower abdominal surgery under spinal anaesthesia by midline or paramedian approach to evaluate incidence of postdural puncture headache at our tertiary hospital. Material and Methods: This prospective and comparative study was conducted 120 patients undergoing elective lower abdominal surgery under spinal anaesthesia were considered for present study. Patients were randomly divided in double‑blind fashion (patient and observer were blind to procedure) into two groups of 60 each. Numeric visual analog pain score was used to assess the postdural puncture headache in both the groups. Any case of persistent postdural puncture backache after discharge was followed up to 7 days through telephonic communication with the patient. The data collected was analysed statistically. Quantitative variables were expressed as Mean ± SD (standard deviation) while qualitative variables were expressed as relative frequency and percentage. The PDPH was analysed using Chi square test. P-value <0.05 was considered as statistically significant. Results:120 patients undergoing elective lower abdominal surgery under spinal anaesthesia were randomly divided in double‑blind fashion (patient and observer were blind to procedure) into two groups as Group M (median approach) and Group P (paramedian approach) of 60 patients each. General characteristics such as age, weight, gender and ASA status were comparable in both groups. Intra-operative hypotension was noted in 10% patients of group M and 8% patients of group P, difference was not statistically significant. 3 % patients of group M and group P required medications (tramadol / paracetamol) to treat PDPH.In present study postdural puncture headache was mild in 8 % and moderate in 3% patients in group M. While 7% patients had mild and 3% patients had moderate postdural puncture headache in group P. Incidence of postdural puncture headache was 10% in group M and 8% in group P, difference was not statistically significant. Conclusion: There was no difference regarding the incidence of PDPH in median and paramedian approach for spinal anaesthesia.

A UNIQUE CASE OF BILATERAL VOCAL FOLD PARALYSIS FOLLOWING SPINAL ANAESTHESIA

Cranial nerve palsies are potential but rare complications of spinal anaesthesia. Most of the literatures support upper cranial nerve palsies like VI, IV and III cranial nerve palsies. Intrathecal hypotension resulting in tractional injury of the cranial nerves is the likely mechanism of injury. As on date, some cases of unilateral vocal fold paralysis and very little bilateral vocal fold paralysis have been described in case reports. We have described a patient who developed hoarseness and dysphagia 7 days after receiving spinal anaesthesia for fixation of inter-trochanteric fracture femur. The patient was diagnosed with bilateral vocal fold paralysis. He was managed conservatively and exhibited complete spontaneous recovery as has been described in the previously reported cases. Any patient presenting with idiopathic vocal fold paralysis should be enquired about the history of spinal or epidural anaesthesia. If the history is affirmative, then it points towards transient intrathecal hypotension as a potential etiology of the cranial nerve palsy.

Intrathecal blood injection: a case report of a rare complication of an epidural blood patch

BackgroundIntrathecal injection is a rare complication of spinal anesthesia and an underreported complication of epidural blood patches. Although there are other reported cases of intrathecal blood injection, these cases lack confirmatory imaging and others report injection of mixed blood with other agents.Case presentationWe present a case report of post-laminectomy cerebrospinal fluid leak who underwent epidural blood patch placement. CT and MRI brain imaging was obtained, depicting intrathecal blood products. The patient had subsequent seizures and respiratory distress, received supportive care, and returned to baseline after several days.ConclusionThe patient’s clinical course illustrates the potential complications of blood products within CSF, including seizures and respiratory distress, which improved with supportive care in this case. Importantly, to our knowledge, this is the only report that clearly depicts injection of purely blood products, without other confounding agents (such as gadolinium), into intrathecal space and with diffuse spread through the CSF as visualized on CT and MRI imaging.

Complication of Spinal Anesthesia in Caesarean Section

Objective
 To evaluate the frequency of maternal complications during spinal anesthesia and within 48 hour post C/S .
 
 Patients and Methods :-
 The Study was conducted in the department of gynecology in AL-Zahra'a Teaching Hospital . The Study comprised of 300 patients who underwent caesarean section under spinal anesthesia alone or with use of assisted drugs for sedation during induction of spinal anesthesia .
 Patients were followed within 48hre post – operative to see any complication which were documented .
 
 Result 
 48.33% (n = 145) were between 17 – 25 years , 27% (n = 81) were between 26 – 30 y . Regarding mode of admission 61.33% (n = 184) booked while 38.67% (n = 116) were unbooked . parity distribution revealed 65% (n = 195) multigravida and 35% (n = 105) primigravida .
 35% (n = 105) suffered from hypotension (Intra – operatively) 15.33% (n = 46) from hypotension (post operatively) .
 Other complication occur shortly after operation include , headache 11% (n = 33) , shiveriy 7% (n = 21) , Backache 4% (n = 12) , Bradycardia 2.33% (n = 7) and urinary retention 2% (n = 6) .
 However , 38 , 67% (n = 116) had no complication of spinal anaesthesia .
 Conclusion
 Spinal anaesthesiaconveyssignificant advantages due to the simplicity of its use and rapid onset of action.