NGHIÊN CỨU CÁC YẾU TỐ LIÊN QUAN ĐẾN THÀNH CÔNG CỦA GÂY TÊ TỦY SỐNG ĐỂ MỔ LẤY THAI TẠI BỆNH VIỆN ĐA KHOA HỒNG NGỌC – PHÚC TRƯỜNG MINH

Abstract

common, straightforward, and safe anesthetic technique for patients undergoing cesarean sections. However, challenges such as difficult access, anesthesia failure, and complications are frequently encountered. This study aims to investigate the factors that predict the difficulty of administering spinal anesthesia, the success rate of the procedure, and the incidence of side effects and complications associated with it. Methods: A total of 105 pregnant women scheduled for elective or urgent cesarean sections under spinal anesthesia were included in this study. Demographic information, body appearance, and the presence of a prior epidural catheter were recorded. Spinal anesthesia was administered with the patient in a lateral lying position, using a Quincke 27-gauge needle at the L2-3 or L3-4 intervertebral space, following a midline approach. All patients received an adjusted dose of hyperbaric bupivacaine combined with 0.03 mg of fentanyl. The success rate of the anesthetic method and any complications following spinal anesthesia were analyzed. Results: The correlation coefficients between age, weight, body mass index, general body appearance, and the presence of a prior epidural catheter with the difficulty of the spinal anesthesia procedure were not statistically significant (p > 0.05). The first-attempt success rate of the puncture was 84.5%, the mean attempt needed was 1,21 ±0.567 (from 1 to 4 times). The mean dose of bupivacaine administered was 7.85 ± 0.56 mg, which was effective in 97.1% of cases, with a failure rate of only 2.9% (requiring general anesthesia). No major complications were observed. Hypotension occurred in 47.6% of women, with an average duration of 1.57 ± 2.2 minutes, which is considered acceptable. The incidence of vomiting and itching was 3.8% and 5.7%, respectively, both lower than many other reports. There was one case of post-dural puncture headache, which did not require a blood patch for treatment. Conclusion: This research indicates that factors such as increasing age, weight, body mass index, and the presence of a prior epidural catheter are not effective predictors of difficulty in administering spinal anesthesia for cesarean sections. The adjusted dose of hyperbaric bupivacaine (mean dose 7.85 ± 0.56 mg) provided high-quality anesthesia with minimal and acceptable complications.