Prevalence of nasal congestion/stuffiness after spinal anaesthesia: The Nigerian experience

Background: Nasal congestion is a complication of neuroaxial block that have been reported in a few case reports but sparsely discussed in literatures. Post spinal anaesthesia, there is an attenuation of the sympathetic tone which can result in nasal congestion and stuffiness. Anaesthetists not aware of this complication may become anxious and may panic. Objectives: This study aims to establish the occurrence of nasal congestion/stuffiness after spinal anaesthesia, determine the incidence of nasal congestion/stuffiness after spinal anaesthesia and also determine if nasal congestion is related to post spinal hypotension. Methodology: One hundred and eighty patients with a mean age of 38years classified as American Society of Anaesthesiologists physical status 1-11 scheduled for subarachnoid blocks were recruited. After establishing spinal anaesthesia, patients were assessed for nasal stuffiness over 30minutes. Results: There were 63 males and 117 females. The prevalence of nasal stuffiness was about 15.0%. 47 of the 117 females recruited had caesarean section, 12 (25.5%) of whom experienced nasal stuffiness. A total of 34 patients experienced hypotension, 19 (55%) of them experienced nasal stuffiness. Nasal stuffiness appears to occur more in pregnant women and is closely related to hypotension in this population. Hypotension appeared to occur randomly in the remaining 15 patients that experienced nasal stuffiness. Conclusion: This study established the occurrence of nasal congestion/stuffiness post spinal anaesthesia. The incidence of which appears to be associated with hypotension especially in parturients. Patient should be monitored hemodynamically as nasal stuffiness could indicate a cephalad spread of the local anaesthetic agent or a pronounced effect on the autonomic nervous system.