Many conversions to general anaesthesia follow an inadequate block that was not formally tested. Testing to cold and light touch, aiming for a sensory level of about T4 to T5, before the surgeon starts identifies a block that needs more time, a top-up or a different plan while there are still options.
Record the level and the modality tested. If the block is patchy, say so to the obstetric team before incision rather than after.
- Test the block bilaterally before incision and record the level and modality.
- Aim for a sensory block to about T4-T5 to cold or light touch.
- Tell the obstetric team if the block is not ready, before the knife is picked up.
- Have a clear plan for intraoperative discomfort, including when to convert.
Why it matters
A block found inadequate after incision leaves fewer and worse options.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for anaesthesiology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free