• Ronaldo Rodrigo de Sá Oliveira, Marília Pinheiro Módolo, Glênio Bitencourt Mizubuti, Anthony M H Ho, Guilherme Antonio Moreira de Barros, Leopoldo Muniz da Silva, Leandro Gobbo Braz, Norma Sueli Pinheiro Módolo, Andrew G Day, Rachel Phelan, Lais Helena Navarro E Lima, and Eliana Marisa Ganem.
• From the *Department of Anesthesiology, Botucatu Medical School- Universidade. Estadual Paulista, Botucatu, São Paulo, Brazil; †Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada; ‡Department of Anesthesiology, São Luis Hospital, São Paulo, São Paulo, Brazil; §Department of Critical Care Medicine, Kingston General Hospital Research Institute, Kingston, Ontario, Canada; and ‖Department of Anesthesiology, Queen's University, Kingston, Ontario, Canada.
• Anesth. Analg. 2017 May 1; 124 (5): 1674-1677.

AbstractIntrathecal local anesthetic maldistribution is a well-known cause of spinal anesthesia failure (SAF). This could potentially result in sensory blockade restricted to the sacral dermatomes. We sought to determine the overall incidence of SAF and the role of sacral dermatomes in differentiating between total and partial failures. Of the 3111 spinals prospectively examined, 194 (6.2%) were classified as failures. Of the 72 presumed total failures based on the initial assessment, evaluation of the sacral dermatomes revealed sensory blockade in 32 (44%; 95% confidence interval, 32.7%-56.6%). Sacral dermatome assessment after SAF may be important in safely guiding subsequent anesthetic management.

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