The relation between body mass index and difficulty in inducing spinal anesthesia in elective cesarean section

Mahrous, Reham; Alalfy, Mahmoud; Abdalgeleel, Shaimaa Abdalaleem; Abdelnasser, Amr; Abd Elfattah, Doaa A.; Hassen, Hatem; Ibrahim Ogila, Asmaa; Ibrahim, Mohamed Ahmed

doi:TEJA-2021-0100

The relation between body mass index and difficulty in inducing spinal anesthesia in elective cesarean section

Authors

TEJA-2021-0100

Abstract

Introduction
Increasing numbers of people globally are affected by obesity, and the number of obese parturient women has correspondingly risen. For obese parturient women, neuraxial anesthetic procedures are generally safe. As the body mass index (BMI) increases, spinal anesthesia becomes more challenging, with a larger failure rate.
Methodology
A total of 383 parturient women were included in this research. They were assigned to three groups according to BMI: Group 1 included 157 women with a BMI of <30; group 2 included 189 women with a BMI of 30–40, and group 3 included 37 women with a BMI of >40. Participants’ ages, weights, and heights were documented, and the number of attempts at inducing spinal anesthesia during labor was counted. Every new skin puncture was considered a new attempt. The success or failure of the blockade was noted.
Results
In pregnant participants, we found that BMI was a reliable predictor of difficulty with the neuraxial technique of inducing spinal anesthesia. We found a weakly positive correlation ( = 0.132) between BMI and the number of attempts to induce spinal anesthesia. This association was statistically significant ( = 0.01).
Conclusion
In pregnant patients, especially those who are obese and have a substantial amount of fatty tissue in the back, anesthesiologists should check the patient’s back thoroughly during the initial patient encounter. We also advise that anesthesia induction be carried out by an experienced senior anesthesiologist.

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