ปัจจัยที่มีผลต่อความสำเร็จของการฉีดยาชาเข้าช่องไขสันหลังในโรงพยาบาลดำเนินสะดวก

บทคัดย่อ

Objective : To determine predicting factors for successful spinal anesthesia, incidence of failed spinal anesthesia and complications in Damneonsaduak hospital.

Methods: A retrospective study was performed in 224 patients undergoing spinal anesthesia during October 2007 to February 2008. The patient’s demographic data, BMI spinal anatomical landmark, patient position, technique, provider experience, outcome and complications. The univariate analysis and logistic regression were used for statistical analysis.

Results:  Success rate of spinal anesthesia was 80% and failure was 20%. Predicting factors (Odd ratio, 95% confidence intervals) of successful spinal block were the anatomical landmark (1.71, 0.55-5.34 ), the quality of position during block (1.81, 0.39-3.16) the performed spinous level (1.63, 1-1.9), obstetrics surgical (1.86, 0.06-3.87)and experience of performers (1.66, 0.03-1.73 ). For complications of spinal anesthesia, there was no statistical significant difference between success and failure group in hypotension and high block but there was statistical significant difference in PDPH (P = 0.001) and backache (P = 0.003) and no neurological complication was found.

Conclusions: The incidence of failed spinal anesthesia was 20%.The final logistic regression model identified five factors of successful spinal anesthesia which were the anatomical landmark, effective positioning, the performed spinous level, performer experience and obstetrics surgical.