Failed Spinal Anaesthesia- A Review

Background: Spinal Anaesthesia is the most commonly used and reliable technique of neuraxial blockade. Possibility of complete or partial failure has been recognized. Dealing with a spinal anaesthetic which is in some way inadequate can be very difficult. Failed subarachnoid block exposes patients to unfavourable experiences of pain and complications of general anaesthesia if given, so the technique must be performed meticulously in a way which minimizes the risk of failure. The present review of failed spinal anaesthesia has considered mechanism of failure which could be due to faulty technique, drug preparation, drug action and anatomical variations in patient's spine leading to abnormal spread of drug. Alternative options for management of inadequate or failed block like repeating the injection, posture correction and sometimes infiltration of local anaesthestics in case of partial block along with sedation. Full documentation of whole procedure including possible cause of failure and events occurred.