Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

Abstract

Introduction

Neuraxial anesthetic techniques are the method of choice for cesarean section (CS) deliveries, and spinal anesthesia (SA) is the preferred technique. Although the use of SA has greatly improved the outcomes of CS deliveries, SA-related complications are still a matter of concern. The study's primary aim is to measure the incidence of SA complications after a CS, specifically hypotension, bradycardia, and prolonged recovery, as well as to identify the risk factors for these complications.

Method

The data of patients who had elective CS using SA from January 2019 to December 2020 was collected from a tertiary hospital in Jeddah, Saudi Arabia. The study design was a retrospective cohort study. The data collected included age, BMI, gestational age, comorbidities, the SA drug and dosage used, the site of the spinal puncture, and the patient's position during the spinal block. Also, the patient's blood pressure measurements, heart rate, and oxygen saturation levels were collected at baseline and at 5, 10, 15, and 20 minutes. SPSS was used for statistical analysis.

Results

The incidence of mild, moderate, and severe hypotension was 31.4%, 23.9%, and 30.1%, respectively. In addition, 15.1% of the patients experienced bradycardia, with 37.4% experiencing a prolonged recovery. Two factors were associated with hypotension, including BMI and the dosage of the SA, with a p-value of 0.008 and a p-value of 0.009, respectively. The site of the SA punctures equal to or lower than L2 was the only factor associated with bradycardia (p-value = 0.043).

Conclusion

The present study concludes that BMI and the dose of SA were the factors associated with SA-induced hypotension during a CS, and the site of the SA puncture equal to or lower than L2 was the only risk factor associated with spinal anesthesia-induced bradycardia.