RESUMO
The goal of this prospective work is to study the per- and post-operative complications of spinal anaesthesia for cesarean and to evaluate their management. We included in the study all parturients undergoing cesarean section to the maternity of hospital Aristide Le Dantec since December 1998 to March 1999. Patients presented contra-indications of spinal anaesthesia, arterial hypertension and/or acute fetal distress were excluded. After a vascular preload of 1000 ml of Ringer lactate, a spinal anaesthesia was realized through a 25 G needle between L3 and L4 in a sitting position with 12.5 mg of 0.5% bupivacain associated with 1 ml of 10% dextrose. Patients were installed after a left light lateral position and oxygenated via a facial mask with 3 1 per mn until the extraction of the child. Studied parameters are following: the sensitive level block before surgical incision, per- and post-operative complications and their management. Sensitive level block was up to T4 in 14.9%, between T4 and T6 in 74.6% and at T8 in 23.6%. Maternal hypotension was the only per-operative complication in our study: 52% with 2 cases of cardiac arrest who needed tracheal intubation and injection of epinephrine. Post operative complications were represented by post-dural headaches about 5.4% and no epidural blood-patch were necessary for their management. We have noted any neurological or infectious complication during supervision of our patients.