International Journal of Obstetric Anesthesia
Volume 15, Issue 4 , Pages 294-297 , October 2006

At caesarean section under regional anaesthesia, it is essential to test sensory block with light touch before allowing surgery to start

    Proposer:
  • I.F. Russell

      Affiliations

    • Corresponding Author InformationI.F. Russell, Consultant Anaesthetist, Hull Royal Infirmary, UK. Tel.: +44 1482 674542; fax: +44 1482 674371.

References 

  1. Yentis S. Height of confusion: assessing regional blocks before caesarean section. Int J Obstet Anesth. 2006;15:2–6
  2. Hollmén A. Axillary plexus block. A double blind study of 59 cases using mepivacaine and LAC-43. Acta Anaesthesiol Scand. 1966;(suppl XXI):53–65
  3. Greene NM. Area of differential block in spinal anesthesia with hyperbaric tetracaine. Anesthesiology. 1958;10:45–49
  4. Brull SJ, Greene NM. Time course of zones of differential sensory blockade during spinal anesthesia with hyperbaric tetracaine or bupivacaine. Anesth Analg. 1989;69:342–347
  5. Brull SJ, Greene NM. Zones of differential sensory block during extradural anaesthesia. Br J Anaesth. 1991;66:651–655
  6. Stevens RA, Bray JG, Artuso JD, Kao T, Spitzer L. Differential epidural block. Reg Anesth. 1992;17:22–25
  7. White JL, Stevens RA, Beardsley D, Teague PJ, Kao T. Differential epidural block. Does the choice of local anesthetic matter? Reg Anesth. 1994;19:335–338
  8. Norris MC. Obstetric Anesthesia. 2nd ed.. Philadelphia: Lippincott Williams & Wilkins; 1999;428
  9. Holdcroft A, Thomas TA. Principles and Practice of Obstetric Anaesthesia. Oxford: Blackwell; 2000;261
  10. Yentis SM, Brighouse D, May A, Bogod D, Elton C. Analgesia & anaesthesia in pregnancy. A practical guide. London: W B Saunders; 2001;92
  11. Bourne TM, DeMelo AE, Bastianpillai BA, May AE. A survey of how British obstetric anaesthetists test regional anaesthesia before caesarean section. Anaesthesia. 1997;52:901–903
  12. Sodhi M, Tamilselvan P, Fernando R, Venkatesh S. How obstetric anaesthetists test the quality of regional anaesthetic block before caesarean section: a national survey. Int J Obstet Anesth. 2005;14:S8
  13. Choi DH. The futility of using sharp pin-prick (or cold) to assess spinal or epidural anesthesia for cesarean section. Reg Anesth Pain Med. 2001;26:385–386
  14. Russell IF. Levels of anaesthesia and intraoperative pain at caesarean section under regional block. Int J Obstet Anesth. 1995;4:71–77
  15. Russell IF. A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section. Int J Obstet Anesth. 2004;13:146–152
  16. Perumal T, Fernando R, Bray J, Columb M. A comparison of cold and touch dermatomal levels using ethyl chloride spray during spinal anesthesia for cesarean section. ASA abstracts 2004; A 183. (http://www.asaabstracts.com/strands/asaabstracts/abstract.htm; jsessionid=AFCA794E069DC819DCBBF053E9F7D7C9?year=2004 & index=14& absnum=1469).
  17. Inglis A, Daniel M, McGrady E. Maternal position during induction of spinal anaesthesia for Caesarean section. A comparison of right lateral and sitting position. Anaesthesia. 1995;50:363–365
  18. Sarvela PJ, Halonen PM, Korttila KT. Comparison of 9 mg of intrathecal plain and hyperbaric bupivacaine both with fentanyl for cesarean delivery. Anesth Analg. 1999;89:1257–1262
  19. McNally T. Anti-Terrorism Review. Lords Hansard 2004; 658: Column 789 (4 March). http://www.publications.parliament.uk/pa/ld200304/ldhansrd/vo040304/text/40304-04.htm.
  20. Oyston J. A guide to spinal anaesthesia for caesarean section for anaesthetists and anesthesiologists. http://www.oyston.com/anaes/local/spinalcs.html.
  21. Wildsmith JAW. Sacred cows and shibboleths. Caesarean section demands a block to …?. Royal College of Anaesthetists Bulletin. 2004;26:1316–1317http://www.rcoa.ac.uk/docs/B26_Shibboleths.pdf
  22. Santos A, Pedersen H, Finster M, Edström H. Hyperbaric bupivacaine for spinal anesthesia in cesarean section. Anesth Analg. 1984;63:1009–1013
  23. Pan P, Lin ZF, Lim J, Tung MC, Wei TT. The optimal dose of hyperbaric tetracaine spinal anesthesia for cesarean section. Acta Anaesthesiologica Sinica. 1989;27:349–352
  24. Pedersen H, Santos AC, Steinberg ES, Schapiro HM, Harmon TW, Finster M. Incidence of visceral pain during cesarean section: the effect of varying doses of spinal bupivacaine. Anesth Analg. 1989;69:46–49
  25. Alahuhta S, Kangas-Saarela T, Hollmén AI, Edström HH. Visceral pain during caesarean section under spinal and epidural anaesthesia with bupivacaine. Acta Anaesth Scand. 1990;34:95–98
  26. Hirabayashi Y, Saitoh K, Fukuda H, Shimizu R. Visceral pain during caesarean section: effect of varying doses of spinal amethocaine. Br J Anaesth. 1995;75:266–268
  27. Chung CJ, Bae SH, Chae KY, Chin YJ. Spinal anaesthesia with 0.25% hyperbaric bupivacaine for caesarean section: effects of volume. Br J Anaesth. 1996;77:145–149
  28. Choi DH, Ahn HJ, Kim MH. Bupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth. 2000;25:240–245
  29. Khaw KS, Ngan Kee WD, Wong ELY, Liu JYW, Chung R. Spinal ropivacaine for cesarean section. A dose finding study. Anesthesiology. 2001;95:1346–1350
  30. Kiran S, Singal NK. A comparative study of three different doses of 0.5% hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section. Int J Obstet Anesth. 2002;11:185–189
  31. Hutter CDD. Assessing the block for caesarean section. Int J Obstet Anesth. 2001;10:328
  32. Jain K, Grover VK, Mahajan R, Batra YK. Effect of varying doses of fentanyl with low dose spinal bupivacaine for caesarean delivery in patients with pregnancy-induced hypertension. Int J Obstet Anesth. 2004;13:215–220
  33. Chung CJ, Choi SR, Yeo KH, Park HS, Lee SI, Chin YJ. Hyperbaric spinal ropivacaine for cesarean delivery: A comparison to hyperbaric bupivacaine. Anesth Analg. 2001;93:157–161
  34. Parpaglioni R, Frigo MG, Lemma A, Sebastiani M, Barbati G, Celleno D. Minimum local anaesthetic dose (MLAD) of intrathecal levobupivacaine and ropivacaine for caesarean section. Anaesthesia. 2006;61:110–115
  35. Saravanan S, Robinson APC, Qayoum Dar A, Columb MO, Lyons GR. Minimum dose of intrathecal diamorphine required to prevent intraoperative supplementation of spinal anaesthesia for caesarean section. Br J Anaesth. 2003;91:368–372
  36. Akerman N, Saxena S, Wilson R, Columb M, Lyons G. Effect of intrathecal diamorphine on block height during spinal anaesthesia for Caesarean section with bupivacaine. Br J Anaesth. 2005;94:843–847
  37. Kestin IG. Assessing the block for caesarean section: more thoughts. Int J Obstet Anesth. 2002;11:146–147
  38. Zaidi AS, Russell IF. Is transcutaneous electrical stimulation a realistic surrogate for genuine surgical stimulation during spinal anesthesia for cesarean delivery?. Anesth Analg. 2005;100:1477–1481
  39. Kinsella SM. Rate of pain during caesarean section after block testing using loss of cold sensation. Int J Obstet Anesth. 2005;14:S32

PII: S0959-289X(06)00108-7

doi: 10.1016/j.ijoa.2006.06.006

International Journal of Obstetric Anesthesia
Volume 15, Issue 4 , Pages 294-297 , October 2006

Article Tools