Spinal Anaesthesia administered by Surgeon : Hospital fined Rs 20 lakh

Spinal anesthesia is an alternative to a general anesthesia and can be used for most operations below the waist. A spinal anesthesia is performed by an anesthetist. A very fine needle is inserted into the middle of the lower back and local anesthetic is injected through the needle in to the fluid that surrounds the spinal cord.. It further states that spinal anesthetic wil be performed in the anesthetic room or in theatre. Before the spinal anesthesia is given the anesthetist will put a drip in patient’s hand and patient will be attached to a monitor (ECG, blood pressure and oxygen saturations

spinal anesthesia is an important anesthetic technique in anesthesiology. Among possible spinal block anesthesia related complications cardio pulmonary arrest is the most serious. The increased knowledge on the physiology of spinal anesthesia together with use of less toxic local anesthetics and improved monitoring incidence of cardiac arrest can be reduced. The effects of spinal block anesthesia on the cardiovascular system include reduction of blood pressure and central venous pressure. The sympathetic blockade prooked by spinal anesthesia causes significant peri pheral vasodilation (widening of blood vassels) which results in bradycardia.

It further suggests the precautionary measures like early diagnosis and effective and aggressive treatment are necessary when facing significant bradycardia during spinal anesthesia. It is essential to monitor the respiration, pulse and blood pressure closely. The blood pressure can fall precipitously following induction of spinal anesthesia. Bradycardia is quite common during spinal anesthesia .Patient should be well hydrated before local anesthesia is injected and should have an intravenous infusion in place so that further fluids or vasoconstrictions can be given if hypotension occurs. Hypotension and bradycardia should be treated with intravenous fluids, atropine and vasopressors.Treatment if not started quickly the combination of hypoxia, bradycardia, hypotension may result in cardiac arrest.

The court clearly observed that anaesthesia should have been given by qualified anaesthetist