Incidence of regional anesthesia conversion to general anesthesia during caeserean section at the obstetric theatre, Kenyatta national hospital

Abstract

Background/Introduction: Caesarean section is an abdominal surgery that is increasingly being done in developing countries. Mode of anaesthesia used during this procedure is a marker of good quality care. Regional anaesthesia being the most favoured mode was introduced in 1899 by Bier. However, general anaesthesia still has a role to play in obstetric anaesthesia in situations where regional anaesthesia is contraindicated. Exposure of a mother to both modes of delivery predisposes her to complications of both. This study looked at the incidence of conversion rates of regional anaesthesia to general anaesthesia in mothers undergoing caesarean section. Objective: To determine the incidence rate of conversion from regional anaesthesia to general anaesthesia during caesarean section at the obstetric theatre, Kenyatta National Hospital. Materials and methods: 576 mothers who had caesarean section under spinal anaesthesia were recruited and the study duration was six weeks. Time of conversion, reason of conversion and type of conversion were recorded. Results: Incidence of conversion was 5.8%. In this study 9.7% of elective cases and 5.1% of emergency cases were converted to general anaesthesia, this is a higher rate compared to recommendations by the Royal College of Anaesthetist (RCA) recommendations. Preoperative failure was 41.9% while intraoperative failure was 58.1% of those who converted. The major reason for conversion was prolonged surgery. Conclusion: The conversion rate was higher than the RCA recommendations. Intraoperative conversion rate was higher than preoperative conversion. There was no association between classification of caesarean section and converse