The Hassiakos maneuver: how to test neuraxial anesthesia before Cesarean section

Abstract

The Hassiakos maneuver: how to test neuraxial anesthesia before Cesarean section Aliki Tympa1 , Charalampos Grigoriadis2, * 1 1st Department of Anesthesiology, Medical School, Aretaieion Hospital, University of Athens, 11528 Athens, Greece 2Department of Obstetrics and Gynecology, Leto Maternity Hospital, 11524 Athens, Greece *Correspondence: xarisgrigoriadis@yahoo.gr (Charalampos Grigoriadis) DOI:10.31083/j.ceog4805170 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 25 March 2021 Revised: 8 June 2021 Accepted: 9 June 2021 Published: 15 October 2021 Background: Neuraxial anesthesia has become the technique of choice for cesarean delivery, reducing the risks associated with general anesthesia. Intraoperative discomfort or pain is medical negligence; therefore proper assessment of neuraxial block is of utmost importance. In view of the variety of methods checking neuraxial blocks before cesarean section and lack of specific detail in the so far published literature, we first describe a specific testing maneuver which Professor of Obstetrics and Gynecology Dimitrios Hassiakos developed. Methods: This is a retrospective clinical study. All medical records of parturients who underwent elective cesarean section under neuraxial anesthesia between April 2015 and December 2020 with the same surgical team, were analyzed. Results: In all cases, the Hassiakos maneuver was performed prior to cesarean section. Abscence of pain during the maneuver was necessary in order to start incision. No case of intra-operative pain was reported. Discussion: Several tests are available in order to check the level of neuraxial block for cesarean section. We first describe a simple and reliable testing method, based on deep pressure of the pyramidalis muscle. Keywords Epidural; Neuraxial anesthesia; Pain; Caesarean section