Assessment of block height for satisfactory spinal anaesthesia for caesarean section in Kenyatta national hospital

Abstract

Background Spinal anaesthesia (SA) is the most common anaesthetic technique in use for the facilitation of caesarean delivery, both locally as well as internationally due to its various advantages over alternative methods. Confirmation of the level of spinal block prior to beginning the surgery is mandatory, to ensure adequate block for maximal patient comfort intraoperatively. It also gives the anaesthesia practitioner an indication of spread of spinal block higher than intended, allowing early intervention and avoidance of complications. Objective To assess and record the level and density of sensory and motor block being achieved by spinal anaesthesia for caesarean delivery in Kenyatta National Hospital. Methodology After obtaining informed consent from patients planned for caesarean section, spinal anaesthesia was administered as per the current protocol in Kenyatta National Hospital (KNH) maternity theatre. The patient was then positioned on the operating table. The different sensory modalities and motor block assessments were performed sequentially on each side and the highest dermatomal level reported by the patient was recorded on a chart. The assessment was performed 2 minutes after drug administration, with a repeat assessment after 5 minutes and 8 minutes, before surgery was begun. Any intraoperative event, rescue analgesia administered or change in anaesthetic technique was recorded.