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What kind of anesthesia is given for the second caesarean section. Types of anesthesia for caesarean section. When indicated, contraindications

As a rule, general anesthesia is used, since it requires less time (compared to regional, local methods). During general anesthesia, a woman falls into a deep sleep, sees, hears, and feels nothing. General anesthesia is also used quite often.

In this article we will look at how this type of anesthesia is performed, what are the indications for its use, the disadvantages (complications) and advantages of general anesthesia.

How is general anesthesia performed?

When using general anesthesia for a planned operation, preoperative preparation measures come to the fore, taking into account the condition of the fetus, the woman’s objective data and the choice of anesthesia.

On the eve of a planned operation, it is advisable to prescribe sedatives in order to achieve psychological peace and eliminate fear of the operation. Premedication (pre-medication preparation) is performed 30 minutes before surgery. It is carried out with the aim of preventing preoperative experiences of women, preventing allergic reactions, and enhancing the effect of pain medications.

General (also known as endotracheal) anesthesia is performed sequentially, in three stages.

A woman is injected intravenously with a drug that completely turns off consciousness and puts her to sleep.
A tube is inserted into the trachea (lower part of the windpipe) and a mixture of oxygen and anesthetic gas flows through it.
A drug is injected that relaxes all the muscles of the body, including the uterus.

After this, the operation itself begins.

Advantages of general anesthesia for caesarean section

The immediate effect of anesthesia is very important during emergency operations, when every minute counts;
This is a long-tested procedure that does not require special skill of an anesthesiologist;
Stable functioning of the cardiovascular system during the operation;
There is a low chance that your blood pressure will drop during surgery. Let us remember that a drop in blood pressure in the mother leads to disruption of blood flow to the placenta and fetal hypoxia.
Control of the strength of the anesthesia, there is always the opportunity to extend the anesthesia if necessary.
The woman’s body muscles are completely relaxed, which is convenient for the surgeon’s work.
Modern drugs for general anesthesia are made in such a way that their negative impact on the child is minimized.
The woman is asleep and cannot (even if she wanted) to worry about anything. She doesn't see the operation. With local types of anesthesia, she also does not see the operation area itself; there is a screen there. But she hears everything, sees the doctors’ faces, and so on. But under general anesthesia, she doesn’t see, doesn’t hear, doesn’t feel, and doesn’t worry.

Note. This can hardly be regarded as a “plus”, but both times I personally reacted to general anesthesia with a state close to euphoria. This state lasted about a day (). I was absolutely happy with everything that was happening.

Disadvantages and complications of general anesthesia for caesarean section

The most common is cough and sore throat (after insertion of a tube with an oxygen and anesthesia mixture). This is not very pleasant, because the stitch hurts, and it’s scary to even think about coughing. As a rule, it is enough to clear your throat (cough several times) two to three times a day. Try to hold your stomach in the area of the seam, it will hurt less. If you cough in your sleep, it is better to try to sit down or stand up, this will put less strain on the stitch.
A fairly common complication: dizziness, weakness, muscle pain, confusion, nausea. With modern drugs it is less common than before.
More rare complications: pneumonia, respiratory tract infections, allergic reactions.

Complications during general anesthesia (for a child)

Lethargy of the child, increased sleepiness. The baby may cry less and move less.
Disturbances in the child's breathing.
Development of perinatal encephalopathy (with toxic effects on the brain of narcotic substances).

In fairness, it must be said that the level of drugs now (2013) is already quite high, and the listed complications in children are rare. And if something does arise, then correction is made in the maternity hospital, and the mother “goes” home with a healthy baby.

Indications for general anesthesia for caesarean section

If .
The patient refused regional anesthesia.
If there are contraindications for local anesthesia.
With transverse, oblique. Note. Today, with a transverse and oblique position of the fetus, the operation can also be performed under regional anesthesia, but this is not a common practice, and the decision will depend on the individual doctor and. The preferences and wishes of the mother in labor are unlikely to be taken into account.
When the umbilical cord loops fall out.
If there are complications that lead to removal of the uterus. For obstetric bleeding.
Systemic infections, some diseases of the central nervous system.

There are practically no contraindications for the use of general anesthesia.

You can read more about choosing anesthesia in the article.

General anesthesia has long been the only type of pain relief for surgical operations. Caesarean section was no exception. The woman in labor had no choice, but there was no debate in favor of one type of anesthesia or another.

Now that there is a choice between epidural, spinal anesthesia and general anesthesia, women are at a loss as to which way is better not to feel pain. In this article we will look at the features, advantages and disadvantages of general anesthesia.

What it is?

The popularity of general anesthesia has decreased markedly in recent years. But not because this type of pain relief is dangerous. In many ways, rumors about its high harm and disastrous consequences for the child are exaggerated.

Simplicity and safety simply come first. A simpler type of pain relief is epidural anesthesia, in which an anesthetic is injected into the epidural space of the spine, blocking the transmission of nerve impulses from the spinal nerves to the brain.

There is unofficial information that the recommendations of the Ministry of Health on the use of spinal anesthesia are due to the relatively inexpensive cost of funds for it, while general anesthesia requires more expensive drugs and a more complex technique.

In any case, women who choose general anesthesia for a planned caesarean section encounter a completely misunderstanding look from the anesthesiologist in the maternity hospital.

They are trying with all their might to convince them that an operation with the patient fully conscious is exactly what any woman in labor dreams of. If the patient insists, the doctors are forced to agree, because the choice of anesthesia method is the legislative right of the patient herself.

General anesthesia does not give a woman the opportunity to see the touching moment of the birth of a baby.

The woman in labor usually meets the baby only a few hours later. But you don’t have to worry about sensitivity, which may be partially preserved during epidural anesthesia - a woman under general anesthesia sleeps soundly and does not feel pain.

Most surgeons do not share the optimism of the Russian Ministry of Health regarding spinal anesthesia. Experts assure that it is easier for them to operate on a woman who is completely relaxed and unconscious than to make sure that the patient does not hear anything unnecessary, does not see what she does not need to see, and fear that she will strain the abdominal muscles, if the blockade was not complete. In addition, answering the patient’s questions at the time of the operation is also not included in the surgeon’s plans, and under local anesthesia, women are usually very sociable.

The most common general anesthesia for caesarean section is endotrecheal.

How is it done?

Many women who have had general anesthesia are quite sure that the medicine was administered intravenously to them, after which they fell asleep. In fact, endotracheal anesthesia is more labor-intensive, but patients usually do not remember its other stages.

If the decision is made to perform the operation under general anesthesia, then the woman begins to prepare for it in advance. If the operation is planned, then it is recommended to go to the hospital in advance to do all the necessary tests and undergo premedication. If the operation is performed urgently, then general anesthesia is performed automatically, without asking the woman about her preferences. In all cases when it is necessary to deeply anesthetize and quickly remove the baby, endotracheal anesthesia is the only reasonable option.

Preparation involves taking a barbiturate drug, usually in tablet form. Premedication is necessary to ensure that the woman gets a good night's sleep the night before surgery. Sound sleep improves blood pressure levels and prevents spontaneous surges.

On the morning of the operation, an enema is given to cleanse the intestines, the pubis is shaved, and sometimes it is recommended to bandage the lower extremities with elastic bandages to prevent thrombosis.

In the operating room, the patient is given a dose of atropine, which should protect her heart from the possible risk of stopping in deep drug-induced sleep. The surgical team then begins to prepare for the operation, and the anesthesiologist checks the blood pressure level, pulse and administers anesthetic intravenously. This drug causes you to fall asleep quickly. The rest happens without her participation, as she moves from different stages of medicated sleep to subsequent ones and sometimes dreams, and sometimes she is simply temporarily “absent”. It all depends on the depth of anesthesia.

As soon as the doctor is sure that the patient is sleeping soundly and does not respond to touch, he inserts a special tube into the trachea of the woman in labor. It will ensure the process of pulmonary breathing during the operation, since the woman will not breathe on her own.

Oxygen, sometimes mixed with nitrogen, begins to flow into the patient’s body through the tube. Sometimes vapors of narcotic medications are also introduced into the inhaled mixture. The tube is connected to a ventilator.

Sometimes doses of drugs are dosed by modern dosage meters, which monitor even the slightest changes in the concentration of a particular gas and drug for drip spraying.

Endotracheal tube insertion

A woman cannot feel pain. Her sleep is very deep, any sensitivity is completely excluded.

The anesthesiologist is nearby and monitors the woman’s condition every minute. If necessary, he adds a dose of anesthetics and muscle relaxants. There is a catheter installed in the woman's vein. If necessary, any medications that the mother's condition may require will be administered through it.

Approximately 15 minutes before the end of the operation, the surgeon notifies the anesthesiologist that support can be stopped, and from this moment a slow and gradual awakening begins. The breathing reflex returns first. This becomes the signal for the anesthesiologist to remove the tube from the trachea. After the operation, the patient is sent to the intensive care ward, where over the next few hours she will have to recover from the state of anesthesia under the supervision of doctors.

Advantages and disadvantages

According to reviews from women and doctors, general anesthesia has several important advantages:

no contraindications;
no pain and psychological fear during surgery;
recovery from anesthesia takes 2-3 hours, but the body finally recovers after 3-4 days;
no back pain, no headaches like after an epidural.

The disadvantages are possible complications. These include:

possibility of injury to the tongue and larynx;
dry cough and sore throat for several days;
delayed meeting with the baby;
the possibility of changes in blood pressure and heart problems under anesthesia;
slight nausea and dizziness for several days after surgery;
the child is temporarily affected by the drugs, but this passes.

An anesthesiologist talks about general anesthesia and other types of anesthesia for caesarean section in the following video.

When natural childbirth is contraindicated, the woman is given anesthesia for a caesarean section. If the operation is planned, then the expectant mother has the opportunity to prepare for it. In such a situation, the woman in labor can independently choose anesthesia for a caesarean section. However, the final decision is made by the anesthesiologist.

Today, when performing a cesarean section, the following types of anesthesia are used: general, epidural and spinal. All have both advantages and disadvantages. Therefore, it is necessary to determine which anesthesia for caesarean section is better and in what situations its use is rational.

The nuances of general anesthesia

When normal childbirth is impossible due to any circumstances, a cesarean section is performed under general anesthesia. It is used only in the most emergency cases, since this anesthesia carries a huge risk, unlike other types of anesthesia. Initially, the woman in labor is given an intravenous anesthetic. A few seconds after the onset of action of the injected drug, a tube is placed in the trachea, which provides oxygen and anesthetic gas.

Indications for the use of general anesthesia for caesarean section are not so numerous. However, it is considered mandatory when another type of anesthesia is contraindicated for a woman in labor. For example, she has open bleeding, has had a major operation on the spinal column, or has bleeding disorders. In addition, general anesthesia is recommended in cases where the fetus is at risk.

This anesthesia has a small number of limitations, although there are more than enough disadvantages that have a negative impact on the mother and baby. During such an operation under general anesthesia, gastric juice may enter the lungs, and this can cause pneumonia. Since the drugs used reach the fetus through the placenta, central nervous system depression may occur. Although there is no need to worry too much, because the modern anesthesia drugs used have a minor and short-term effect on the fetus.

The use of general anesthesia for caesarean section can also lead to the development of hypoxia in the woman in labor, which is caused by a lack of oxygen. As a result, her blood pressure may increase, and minor side effects such as muscle pain, nausea, and cough are possible.

Despite the huge number of disadvantages, general anesthesia also has certain positive properties. With its help, a rapid immersion in a state of anesthesia occurs. In addition, a woman easily tolerates this type of anesthesia due to the absence of pain. At the same time, the mother’s cardiac system works correctly.

Epidural pain relief

As a rule, it is advisable to use epidural anesthesia for planned cesarean sections.

The doctor injects into a designated area above the spinal column at the lumbar level. An anesthetic drug is injected into the area where the nerves exit the spinal cord in the spinal canal using a thin catheter. If necessary, you can add medicine through it. During the operation, the woman in labor is conscious, but she lacks sensitivity in all organs below the waist. The patient does not feel the lower part of her own body and is unable to move her lower limbs.

Like any other, it is necessary in the following situations:

premature birth (when the gestation period is less than 37 weeks);
high blood pressure;
discoordination of labor;
long labor.

This type of anesthesia also has contraindications. These include:

poor blood clotting;
proximity of pustules to the puncture area;
infectious diseases;
allergic reaction to the drug used;
complicated deformities of the spinal column;
large fetus, narrow pelvis;
the patient’s disagreement with epidural anesthesia and others.

The benefits of an epidural are numerous. For example, a pregnant woman is conscious, and this eliminates the possibility of intubation or aspiration. In addition, a woman can monitor the birth process of her child. This anesthesia is good because it does not irritate the upper respiratory tract. Thus, for women in labor who have laryngeal diseases, epidural anesthesia is most suitable. In addition, a caesarean section can take a long time and the anesthesia time can be increased by adding medication through the catheter.

The disadvantages of such anesthesia are the possibility of incorrect intravascular injection, as well as the threat of subarachnoid injection. An additional disadvantage is the inability to quickly begin the operation, since pain relief begins to take effect only after 10-20 minutes. It is possible that unpleasant sensations may occur at the end of the procedure: pain in the head and back, disruption of the process of emptying the bladder, and others.

Spinal anesthesia during surgery

This type is similar to the epidural, but there are some differences. The thing is that during spinal anesthesia the needle must be inserted deeper to ensure puncture of the thick membrane. This type is otherwise called spinal. The puncture is carried out with a thin needle between the 2nd and 3rd, or 3rd and 4th lumbar vertebrae. A small dose of the drug is injected into the space that contains the cerebrospinal fluid.

Contraindications for this type of anesthesia include: the presence of an infection of the dermis in the puncture area, poor blood clotting in a woman in labor, the presence of spinal diseases, sepsis and others.

The positive properties of spinal anesthesia include:

when administered correctly, complete pain relief is ensured;
after administering the painkiller, preparatory work for delivery can be carried out after a couple of minutes;
simplicity of the procedure, which consists in correctly determining the puncture site;
absence of any toxic reactions in case of incorrect intravascular administration of the drug;
low cost.

The disadvantages include the limited period of action of the drug (up to 2 hours) and the likelihood of lowering blood pressure.

A caesarean section is a surgical delivery in which the baby is removed through an incision in the mother's uterus. There are planned caesarean sections and emergency ones. I survived two such operations, as a result of which I have two wonderful daughters. I had a planned caesarean section due to high myopia. If myopia entails changes in the retina of the eye, then cesarean section is the only way of delivery. My first birth took place under general anesthesia, the second under spinal anesthesia. I'll tell you in detail about my feelings.

General anesthesia for caesarean section

I was admitted to the hospital a week before giving birth. Here they put me on IVs, gave me vitamins, and monitored my tests. In general, they prepared for the operation. I gave birth in a rural area, so the choice of anesthesia was small, or rather there was none at all. The day before the operation, the anesthesiologist called me for a conversation and warned me that in this hospital they only provide general anesthesia. Roughly speaking, they will put me to sleep, and I will wake up in the ward, becoming a mommy. Before the operation, I passed control tests and underwent an unpleasant procedure with an enema. And here I am in the operating room. Sensors were attached to one arm to monitor my pulse and blood pressure, and a catheter was inserted into the other arm. I felt like a spread out dissected frog. It was very scary. I was afraid of not falling asleep and feeling everything, afraid of not waking up at all. The fear of the unknown was scary! Before we started, we were given oxygen to breathe using a mask, and then anesthesia was injected into a vein through a catheter. After a couple of minutes, the ceiling began to blur above me. The sensations are very unpleasant and strange. It’s as if I’m flying into some kind of tunnel, and there’s an incomprehensible white sticky mass pressing around me. I hear some kind of growing rumble and really want to get out of here, but I can’t.

And then I opened my eyes. I had a hard time regaining consciousness. I felt very weak, dizzy, and my blood pressure dropped to 70/40. I was very thirsty. I didn’t feel any pain because I was injected with painkillers. And I also wanted to know what was wrong with the child, how was he. I completely recovered from anesthesia only in the evening.

The child was born healthy. Closer to night they brought it to me and showed it to me. I didn’t get out of bed for days. The pain in the suture area was quite tolerable. On the second day, I completely gave up painkillers. I only got up on the third day. But in vain! The sooner you get up, the faster everything will heal. She walked slowly, in a half-bent position. The child was given to me on the fourth day. By this time she was used to eating formula and did not breastfeed. I trained her long and painfully for three months. As for my stitch, on the seventh day, on the day of discharge, I no longer remembered about it. Everything healed very quickly.

My second birth under epidural anesthesia

My second surgery occurred seven years later. This time I was advised to use local anesthesia, as it is more gentle. The beginning was the same as the first time: tests, enema, operating room. They gave an injection to the lower part of the spine. It does not hurt. They hung a curtain in front of me so that I could not see the doctors’ actions. I felt my lower body go numb. I didn’t feel how they cut me. Only when they took the baby out did I feel like something was being pulled out of me, but there was no pain. And then I heard my baby scream. This is such happiness! All mothers will understand me. This is an unforgettable moment. I cried with great joy. They showed me their daughter right away. The whole operation took 40 minutes. At the end, they gave me a sedative injection and took me to the ward. I immediately called all my relatives and told the good news. After the operation I was very chilled, but it was tolerable. Ice was applied to the seam and an anesthetic was injected. I began to feel the lower part of my body after three hours. By evening they lifted me out of bed and I tried to leave. On the second day they gave me the baby, and I fed breast milk without any problems. The stitch hurt for five days. Longer than the first time. But a week later I forgot about him.

To summarize briefly, if you are given a choice of anesthesia, then choose only spinal anesthesia. It is much easier to tolerate; you are conscious throughout the operation. You have the opportunity to see the child and be aware of everything that is happening. This anesthesia is absolutely harmless to the baby.

Recovery after cesarean

After a caesarean section, the most important thing is to get out of bed as early as possible. Even if it hurts, it’s hard, your head is spinning, but you have to overcome it, force yourself. Otherwise, the seam will heal slowly, and adhesions will also form. Do you need this? As soon as you come to your senses, try not to lie on your back all the time, but turn first to one side, then to the other. And after six hours, rise slowly. Do not hurry! Sit on the bed for five minutes, and then, with the help of one of your relatives, take a couple of steps. Walk around a little, lie down, relax. I know from myself that I really want to lie down, but I have to overcome myself. It is very important to separate in the first days. Thanks to this, you will be able to walk without problems on the third day after surgery. When you breastfeed, you will feel pain in the uterine area and increased bleeding. This is fine! When a baby sucks at the breast, the uterus contracts. Be sure to wear a bandage. With its help, there will be no pressure on the seam, and it will heal faster. After discharge, treat the seam with brilliant green for five days. I took a bath on the second day after the operation. After six months you can start exercising.

Restoring shape after a cesarean section is slower because the abdominal muscles are cut. It took me two years. But thanks to these operations, I have two wonderful daughters, I have no deterioration in my vision, and I no longer even remember the operations. The seam has long since healed and turned pale. It is absolutely invisible under underwear. Giving birth through surgery is not scary. The main thing is to think about your baby. Health to you and your children!

A caesarean section is a surgical delivery in which the baby is removed through an incision in the mother's abdominal wall and uterus. Today this operation is completely safe and is actively used in obstetrics. You can read more about the operation in the article, but now we’ll talk about how a caesarean section is anesthetized.

Today, the following are used as anesthesia for caesarean section:

General anesthesia.
Spinal anesthesia.
Epidural anesthesia.

Spinal and epidural anesthesia is also called regional anesthesia.

General anesthesia

General endotracheal anesthesia for elective caesarean section is being performed less and less today. However, this is what is done when the operation needs to be performed urgently, and there is no time to wait for the anesthesiologist to perform regional anesthesia.

The manipulation takes place in several stages. First, a drug is injected into a woman’s vein, putting her into a medicated sleep and turning off consciousness. Then a tube is inserted into the trachea to supply a mixture of oxygen and anesthetic gas and artificial ventilation of the lungs. The effect of anesthesia, with proper administration of drugs, appears almost instantly. The woman is completely unconscious.

Advantages of general anesthesia for caesarean section

immediate action in case of urgent surgery;
low risk of falling blood pressure, stable functioning of the cardiovascular system;
complete relaxation of the mother’s body muscles, which is very convenient for the surgeon;
the possibility of timely extension of action through additional injections, control of the depth of anesthesia;
the opportunity for the mother not to see the operation if she is frightened by such a prospect (despite the fact that even with regional anesthesia, she still will not see the progress of the operation, since a screen will be installed at chest level).

Disadvantages and complications after general anesthesia

General anesthetics can influence the child. This is expressed in some oppression muscle activity, nervous and respiratory systems of the baby. As a rule, this effect is short-lived and is expressed in the fact that after extraction the child is inactive and does not scream in the first seconds.

But there are also cases of subsequent development of complications, up to hypoxic-ischemic encephalopathy; it all depends on what dose of drugs was administered to the woman and how quickly the baby was removed. However, medicine does not stand still, and every year new drugs appear that minimize the negative impact on the child.

Opportunity severe "departure" from anesthesia. Here everything depends on the individual characteristics of the woman’s body: some suffer from headaches, nausea and confusion for another day after the operation, while others feel great within a few hours.

Irritation and sore throat, cough - all these are the consequences of not very careful actions when installing a tracheal tube, in addition, coughing after a cesarean section gives a woman a lot of unpleasant sensations, so any tension in the abdomen causes pain.

Risk of aspiration– entry of stomach contents into the respiratory system due to the fact that when a tube is inserted into the trachea, vomiting may begin.

Probability effects of drugs on the cardiovascular system, as well as the occurrence of allergic reactions.

Indications

General anesthesia is performed:

during an emergency caesarean section, when there is a threat to the life of the child or mother;
if there is a likelihood of complications leading to removal of the uterus, as well as obstetric bleeding, for example, in the case of placenta previa;
in cases where regional anesthesia is impossible for one reason or another, for example, the mother has a high degree of obesity or spinal injury, low blood pressure, bleeding, and so on.

So, general anesthesia is still quite popular today due to the fact that the hospital does not always have an anesthesiologist capable of performing regional anesthesia or the drugs necessary for this are available. In addition, new drugs are being developed that make general anesthesia increasingly safe for the baby and easily tolerated for the mother.

Regional anesthesia

Anesthesia aimed at local anesthesia is called regional. This includes spinal and epidural. The mechanism of these manipulations is very similar: a puncture is made in the lumbar region of the spine, and anesthetics are supplied through it. As a result of both spinal and epidural anesthesia for caesarean section, pain is relieved in the lower part of the woman's body, while she remains conscious.

The main difference between the types of regional anesthesia for cesarean section is the depth of the puncture and the dose of anesthetics. Let's take a closer look.

Spinal anesthesia

Spinal or, as it is also called, spinal anesthesia for caesarean section can be performed either routinely or urgently, provided that doctors have about 10 minutes left.

The manipulation mechanism is as follows:

A woman needs to sit on the couch with her hands on her knees and arch her back, or lie on her side and pull her legs towards her stomach in order to ensure maximum possible access to the spine;
The woman in labor will be treated with a disinfectant solution around the upcoming puncture;
The anesthesiologist gives an injection of an anesthetic so that the skin and subcutaneous fat lose sensitivity;
A long, thin needle is used to puncture (puncture), an anesthetic is injected into the cerebrospinal fluid (between the vertebrae below the level of the spinal cord);
The needle is removed from the puncture, a sterile napkin is applied and secured with an adhesive plaster.

Pain relief occurs almost instantly. The woman does not feel any pain or tactile sensations.

pros

the risk of drug exposure to the child is completely eliminated;
rapid action within a few minutes is a significant indicator, since along with pain relief the woman’s pressure level in the lower half of the body drops, which leads to hypoxia of the baby, therefore, the sooner he is brought into the world after the start of pain relief, the better;
absolute anesthesia, the risk of partial or insufficient anesthesia is extremely small, in addition, spinal anesthesia for caesarean section provides sufficient muscle relaxation, which facilitates the surgeon’s work;
a small dose of anesthetics compared to epidural anesthesia. Due to this, in case of accidental release of drugs into the bloodstream, the risk of toxic poisoning is reduced;
due to the fact that the woman is conscious, there are usually no breathing problems. If necessary, an oxygen mask can be used;
the woman in labor hears the first cry of her baby and can immediately put him to her breast;
For an anesthesiologist, manipulation of spinal anesthesia during cesarean section requires less effort and qualifications than, for example, during epidural. Consequently, there is less risk of complications or unsuccessful puncture;

Disadvantages and complications after spinal anesthesia

a sharp drop in blood pressure (BP). Due to this inevitable factor in the use of spinal anesthesia, a number of preventive measures are carried out in advance. As a rule, a woman is given drugs that increase blood pressure, but they can negatively affect the child’s nervous system, since, by raising the mother’s blood pressure level to an acceptable level, they will cause increased blood pressure in the baby;
limited exposure time. If with epidural anesthesia it is possible to add anesthetics as needed, then in this case the drugs are administered once - before the start of the operation. If something goes wrong and the operation takes longer than planned, the woman will be urgently transferred to general anesthesia. However, today drugs are used whose effects last up to 2 hours;
high risk of neurological complications associated with the development of headaches.

Epidural anesthesia

Mechanism The manipulation generally repeats spinal anesthesia, but the needle is inserted into the space between the wall of the spinal canal and the hard wall of the spinal cord - into the epidural space, where the nerve roots exit.

A very thin rubber tube is passed along the needle - catheter. The needle is removed from the puncture, but the catheter remains; painkillers are subsequently supplied through it.

The effect of anesthesia develops gradually within 20 minutes after the start of drug administration.

pros

the woman in labor is conscious and can see her baby immediately after birth;
the decrease in blood pressure occurs gradually, which makes it possible to maintain it at normal levels using preventive measures;
the ability to extend pain relief if the operation is prolonged, as well as for the postoperative period. Additionally, if an epidural was used for labor that progressed to an emergency cesarean section, it will continue to be used during surgery.

Disadvantages and complications after epidural anesthesia

if a large dose of anesthetics accidentally enters the bloodstream, toxic poisoning may develop, including convulsions and death;
sometimes epidural anesthesia does not work at all or works partially, for example, numbing only the left or right side;
a complex manipulation that requires a certain level of skill from the anesthesiologist. This also determines the high risk of complications due to errors in execution;
possibility of developing a spinal block. A complication occurs when the puncture is performed incorrectly and anesthetics are injected under the arachnoid membrane of the spinal cord. If a large dose of drugs was administered and help was not provided on time, the woman may experience respiratory arrest, and then cardiac arrest;
the effect of drugs on the child;
Due to the late effect of anesthetics, the start of the operation is delayed by an average of 20 minutes. A drop in blood pressure during this time can lead to prolonged fetal hypoxia.

Contraindications for regional anesthesia for caesarean section

spinal deformities and injuries;
low blood pressure;
inflammation at the puncture site;
intrauterine fetal hypoxia;
existing or suspected bleeding in the mother.

Common complications of regional anesthesia

1. When puncturing the dura mater of the spinal cord cerebrospinal fluid may spill into the epidural space. This complication after a cesarean section is characterized by severe, prolonged pain in the back and head. As a rule, drug treatment is first carried out, and if it does not produce results, a so-called “blood patch” is done.

The essence of the manipulation is that a puncture is performed again, and the woman’s own blood is injected into the epidural space in order to “seal” the puncture of the spinal membrane. This procedure usually produces quick, noticeable results.

2. Probability of development long-term positional compression syndrome. This complication after anesthesia is due to the fact that after the operation the woman in labor does not feel her legs for some time. Sometimes it happens that when transferring her from the gurney to the bed, her leg gets twisted.

If the medical staff did not notice this, and the leg is in an unnatural position for a long time, blood does not flow to it, and this is fraught with the development of serious consequences.

After the limb is returned to its normal position, shock and swelling will begin to develop, all accompanied by pain and difficulty moving.

If you are having regional anesthesia for a caesarean section, be sure to reaffirm to yourself the need to make sure that you are placed on the bed correctly. This way you will save yourself from months of suffering and the use of narcotic painkillers.

Complications of regional anesthesia for a child

So, what is the danger of lowering the mother’s blood pressure during regional anesthesia for cesarean section? The fact is that in such a situation, the blood flow of the placenta is disrupted, and, as a result, the child develops hypoxia. Hypoxia (or oxygen starvation) is fraught with damage to the white matter of the brain, that is, deviations in the development of the central nervous system with all the ensuing consequences.

It is noteworthy that a newborn can show a high score, and the results of hypoxia will appear much later - by 2-3 years.

As you can see, all types of anesthesia have their advantages and disadvantages. In the article we indicated background information so that you can imagine what anesthesia is for a caesarean section.

However, a lot depends on your individual characteristics and medical qualifications. personnel, the drugs used and many other factors that determine the outcome of the operation in general, and the use of anesthesia in particular. In addition, science does not stand still - new methods and drugs are constantly appearing.

Remember that you yourself can choose the type of anesthesia for a planned caesarean section, provided that your choice does not contradict objective contraindications. In order to make the right decision, you should consult a qualified specialist, talk with the doctor who is caring for your pregnancy and an anesthesiologist.

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