Common Complaints Associated with Caesarean Section during Spinal Anaesthesia

Over 20% of deliveries require a caesarean section for the birth of the baby. Caesarean deliveries are performed as an elective or an emergency procedure under General, Spinal, Epidural or combined spinal epidural anaesthesia. The majority of caesarean sections are done under spinal anaesthesia now. Spinal Anaesthesia is preferred for caesarean section because it is simple to perform and is economical. It produces rapid onset of anaesthesia, patients remain awake and alert, associated with less nausea and vomiting, minimal neonatal depression, less incidence of aspiration pneumonitis and adequate muscle relaxation. Spinal anaesthesia produces a fixed duration of anaesthesia and some associated complications include hypotension, shivering, visceral pain or discomfort, nausea, vomiting, and headache during or after the procedure. Sometimes spinal anaesthesia is converted into general anaesthesia. Major maternal complaints during caesarean section under spinal anaesthesia were visceral pain or discomfort. Visceral pain, nausea, vomiting, shivering and other complaints become very severe, therefore sometimes may require general anaesthesia if the patients discomfort cannot be controlled. The conversion rate from spinal to general anaesthesia is 0.7-2.8% and even higher in emergency caesarean section that is 4.9%. Visceral pain is dull, poorly localized and the visceral sensation is described as heaviness squeezing or unpleasant feeling associated with nausea and vomiting. Sometimes it is associated with exteriorization of the uterus. Intra operative nausea and vomiting is uncomfortable to the patients and may cause protrusion of abdominal viscera rendering surgery more difficult and increasing the risk of visceral injury. Patient feels a lot of anxiety and distress during spinal anaesthesia. Anxiety and distress level of anOriginal Article