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Intraoperative management of inadequate neuraxial anaesthesia 

Intraoperative management of inadequate neuraxial anaesthesia
Chapter:
Intraoperative management of inadequate neuraxial anaesthesia
Author(s):

Tauqeer Husain

and Roshan Fernando

DOI:
10.1093/med/9780198713333.003.0021
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date: 18 February 2020

Neuraxial anaesthesia (NA) is the primary form of anaesthesia used for caesarean delivery. The popularity of NA has increased in no small part due to improvements in mortality and morbidity associated with the techniques. However, intraoperative inadequacy of NA might expose patients to the risks of repeated NA techniques, general anaesthesia, and the long-term psychological effects of pain during caesarean delivery. Additionally, clinicians may also become exposed to the medicolegal consequences of failed NA. Prevention of failed NA requires a sound knowledge of the causes and risk factors associated with inadequate NA. Furthermore, an understanding of the effects of different local anaesthetic mixtures, and methods of testing anaesthetic adequacy are also needed. Decisions in the management of inadequate NA must be taken in the context of the urgency of delivery, the maternal risk, and at what point during the operative episode the inadequacy becomes evident.

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