All of us have experienced this: The patient was slim, had a straight back and the entire spinal anesthesia procedure was straightforward. It took only one attempt to get into the subarachnoid space, there was an obvious dural “click”. A clear CSF flow shows up in the hub of the 27G Sprotte spinal needle, and the injection of the spinal anesthetic dose was a breeze. However, 30 minutes later, in dismay, we diagnose a failed spinal anesthetic. Then comes the question: “Where did the local anesthetic go and why did the spinal fail when it all looked so routine?”.
In this video, Dr. Hadzic explains what is the likely reason and how to decrease the chance of failure by implementing one simple strategic step in your technique that should be routine with every spinal anesthetic.
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