Failed spinal anesthesia in addicts: Is it an incidence or coincidence?
Youssef, M., Abdelnaim, H. (2014). Failed spinal anesthesia in addicts: Is it an incidence or coincidence?. EKB Journal Management System, 30(3), 247-253. doi: 10.1016/j.egja.2014.02.001
Maha M.I. Youssef; Hala Ezzat Abdelnaim. "Failed spinal anesthesia in addicts: Is it an incidence or coincidence?". EKB Journal Management System, 30, 3, 2014, 247-253. doi: 10.1016/j.egja.2014.02.001
Youssef, M., Abdelnaim, H. (2014). 'Failed spinal anesthesia in addicts: Is it an incidence or coincidence?', EKB Journal Management System, 30(3), pp. 247-253. doi: 10.1016/j.egja.2014.02.001
Youssef, M., Abdelnaim, H. Failed spinal anesthesia in addicts: Is it an incidence or coincidence?. EKB Journal Management System, 2014; 30(3): 247-253. doi: 10.1016/j.egja.2014.02.001

Failed spinal anesthesia in addicts: Is it an incidence or coincidence?

Egyptian Journal of Anaesthesia
Volume 30, Issue 3, July 2014, Page 247-253  XML PDF (540.82 K)
DOI: 10.1016/j.egja.2014.02.001
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Authors
Maha M.I. Youssef; Hala Ezzat Abdelnaim
Abstract
Background
Drug addiction remarkably increases morbidity and mortality among patients. Several cases of failed spinal anesthesia have been discovered in the clinical practice among addict patients. Different causes of failed spinal blocks have been mentioned in the literature.
Methodology
The study was conducted in Kasr al Ainy teaching hospital, Cairo University, Egypt. One hundred patients aged 20–50, ASA 1-2, both genders, undergoing lower abdominal or limbs surgeries under regional anesthesia, were included in the study. They were divided into 2 equal groups, relative to the addiction history to Marijuana, Cannabis, Tramadol, and Clonazepam. Group [NAD] non-addicts ( = 50); and Group [AD] addicts ( = 50). The success rate, onset, duration of sensory and motor blocks were evaluated. Hemodynamic data were collected, and any complications due to the drugs used or due to spinal anesthesia were recorded.
Results
The incidence of failure of the spinal anesthesia was higher in Group [AD] (33%) than Group [NAD] (4%), ( < 0.05). There was delay in the onset time and decreased duration of both sensory and motor blocks in the addict groups compared to non-addicts. All previous findings showed statistical significant difference ( < 0.05). Hypotension ( < 0.05) and nausea occurred more in addict groups than in non-addicts. No other complications were encountered in the study.
Conclusion
The incidence of failure of the intrathecal anesthesia seemed to be higher in the addict than in non-addict patients. Redo intrathecal injection with a top up 1/2 of the initial dose resulted in success of the block in all failed cases. There was a slower onset and decreased duration of both sensory and motor blocks, with higher incidence of hypotension and nausea more in the addict patients than in non-addicts.
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