Assessing blocks after spinal anaesthesia for elective caesarean section: how different questions affect findings from the same stimulus

Abstract Background A block to touch to T5 is widely used to indicate an adequate level of block for caesarean section with spinal anaesthesia. However, two studies using a “block to light touch” to T5 as their end-point, had a high requirement for intraoperative analgesia and their results cast dou...

Full description

Saved in:
Bibliographic Details
Published in:International journal of obstetric anesthesia 2013-11, Vol.22 (4), p.294-297
Main Authors: Nor, N.M, Russell, I.F
Format: Article
Language:English
Subjects:
Anesthesia & Perioperative Care
Anesthesia, Obstetrical - methods
Anesthesia, Spinal - methods
Caesarean section
Cesarean Section
Elective Surgical Procedures
Female
Humans
Neurotip
Obstetrics and Gynecology
Pregnancy
Sensation
Sensory block assessment
Spinal anaesthesia
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background A block to touch to T5 is widely used to indicate an adequate level of block for caesarean section with spinal anaesthesia. However, two studies using a “block to light touch” to T5 as their end-point, had a high requirement for intraoperative analgesia and their results cast doubt on the adequacy of a block to touch to T5. On enquiry, these two papers did not assess complete block to touch, but asked mothers when the touch sensation “was the same as” a control stimulus. The difference between these two assessment methods is unknown. The current study presents prospectively collected sensory block data which included both block to touch and the level when touch was the same as a control stimulus. Methods The levels of block were assessed using a Neurotip®. The mother was asked four questions to assess the block: first touch level, first sharp level, touch same as control and sharp same as control. Results The first touch level was a median of two dermatomes lower than the touch same as a control level [IQR 0–3, range 0–6]. Block level assessment methods using first sharp and touch same as control were equivalent. Conclusion When describing a sensory block, not only is it necessary to indicate the exact stimulus used, but it is important to define the actual question asked of the patient. Clinically, block assessment using the first sharp level and touch same as control are equivalent.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2013.05.010