Delayed Onset of Regional Anaesthesia in An Elective Sectio Caesarea: A Case Report

Spinal anesthesia (SA) is a popular technique of anesthetic for pregnant women undergoing elective cesarean surgery. The purpose of this study was to present a case of delayed onset of spinal anesthesia in a patient undergoing cesarean section and factors associated with delayed onset of spinal anesthesia. We report a case of a 20-year-old female patient with a diagnosis of G1P0A0 + CPD + Oligohydramnios, 40 weeks of age, who underwent cesarean section with spinal anesthesia using a 26 G Quincke spinal needle and 0.5% hyperbaric bupivacaine (Regivell). 5-8 minutes after the local anesthetic was injected into the intrathecal space, the anesthetic effect should have been given, both legs felt warm and could not be moved (Bromage score 3). However, in this case there was a delay in the onset of sensory and motor block. In the first 10 minutes of the left leg Bromage block was still 2 while in the right leg the Bromage motor block score was 0. Several factors that are suspected to influence this delay are: changes in the physiology of pregnant women, drug dosage, patient psychology, difficult injection techniques, variations in the anatomy of the patient's spine. A thorough understanding of these factors is necessary to improve the effectiveness and safety of spinal anesthesia, especially in obstetric procedures.