“Failed epidural and spinal block for c-section?”
I'm curious about what can cause a failed epidural and spinal blocks? They never worked and I ended up being put to sleep after multiple tries. I have anxiety about trying for another baby now and the same thing happening. Two anesthesiologists were in the room with me and neither knew why they weren’t working.
Female | 28 years old
4 Answers
AnesthesiologistAnesthesiologist
Ultrasound guidance can be used to place the epidural and or spinal needle to increase the accuracy of placement. If you have had a previous lumbar surgery with screws and rods placement, you might need to have a general anesthetic for your cesarean section delivery.
There are many possible causes for a failed epidural block, the most common of which is that the "epidural catheter" is not in the epidural space. A failed spinal block can be due to the movement of the patient or the spinal needle during injection such that not all of the intended spinal local anesthetic is injected and an insufficient block results. Another potential cause of these failures is that the local anesthetic that is used is either beyond its expiration date or has come from a "bad" lot (batch) of drugs in which all of the local anesthetic has gone bad. When a failure occurs, the best option is to get the most experienced, senior anesthesiologist to do your epidural or spinal or combined spinal-epidural anesthetic.
A spinal anesthetic block is an all-or-nothing block. Sensory and motor block is achieved with a single injection. If the local anesthetic is not injected in the subarachnoid space (into the cerebrospinal fluid), there will be no block. With epidural blocks, a small catheter is usually inserted into the epidural space. If you have fibrous partitions in the epidural space, you could potentially result in a patchy block, in which some areas are numb and some areas still have sensation. If you have a history of patchy epidural blocks, you might opt for a spinal block or general anesthetic.
There's a lot of information I would need to answer this question. First, what is the experience level of the docs attempting your regional? How sure were they of their success with performing the block? Have you had any local anesthesia procedures? Do you have any chronic back problems? In my experience, spinal anesthesia is rarely ineffective so I would guess the procedure was not done properly. Epidural anesthesia or analgesia can be more challenging so a higher level of expertise is needed.
