Obstetric Anaesthesia Annual Scientific Meeting 2023

Assessment of neuraxial block and management of intraoperative pain in obstetrics
S Collinson¹, S Coyle¹, J Tupman¹, L England², A Zacharzewski², D Eusuf²
1 North West School of Anaesthesia, Health Education England Northwest, Manchester, UK
2 Department of Anaesthesia, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK

Introduction

•There is no globally accepted definition of an inadequate neuraxial block (NAB) for Caesarean section (CS)

•Loss of light touch to T5 is accepted as ‘adequate NAB’¹

•No single consistent method for NAB assessment

Aims

•To review current NAB testing practice across our trust

•To produce clear guidance on a standardised approach to block testing and management of ‘failed’ block

Method

•Pre-intervention survey of current practice sent to all anaesthetists delivering obstetric anaesthesia

Results

(see diagrams)

Discussion

•Significant difference for both assessment and management of NAB

•Cold touch is the primary sensory modality used

•Alfentanil is the most popular 1st line intraoperative analgesia adjunct

•Pain during CS can have long term psychological sequalae²

•We will establish a consensus and develop an evidence-based algorithm to ensure all individuals receive the same standard of care

References

1 Plaat F, Standford SER, Lucas DN. Prevention and management of intraoperative pain during caesarean section under neuraxial anaesthesia: a technical and interpersonal approach. Anaesthesia. 2022;77:588-597

2 Standford SER. What is ‘genuine’ failure of neuraxial anaesthesia? Anaesthesia. 2022;77:523-526

Obstetric Anaesthesia Annual Scientific Meeting 2023

Assessment of neuraxial block and management of intraoperative pain in obstetrics

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