OBSTETRICS – Team Anaesthesia

OBSTETRICS

Our experienced obstetricians and gynaecologists will
treat your condition. You could choose your preferred
VOG.

1. Caessarian sections
2. D & C
3. Laparascopy Procediures
4. Exploratory Laparatomy
5. Others

Spinal anesthesia for Caessarian sections

Our goal is to keep you safe and comfortable during your procedure.

What to Think About

During a planned C-section, you’re usually given anesthesia to numb the lower half of your body, including the incision area. You’ll remain awake during delivery.

If a C-section becomes necessary during labor, the type of anesthesia used depends on your:

Health and the condition of your baby
Birth preferences

When a C-section is:

Unplanned (and not an emergency), you may have a spinal or epidural, if it’s safe given your medical conditions. You’ll remain awake during delivery.
Urgent, the decision about the type of anesthesia is made during labor. There may or may not be time for a spinal or epidural.
Emergent (an emergency for the mother or baby), you’ll likely be given medicine to make you fall asleep (general anesthesia). We use it when there isn’t enough time or you can’t safely have an epidural or spinal.

Types

We typically use regional anesthesia during a C-section. The types include:

Spinal block
Epidural
Combined spinal-epidural block (CSE)

The anesthesia numbs the lower part of your body. You’ll remain awake during the birth of your baby. With planned C-sections, a spinal block is the most common choice.

If you already have an epidural, we may inject stronger medicine through the tube (catheter). This will fully numb your lower body to prepare you for a C-section.

CSE provides quick, complete, and long-lasting numbness from your abdomen to your legs. It’s used in about 20 percent of all C-sections.

General anesthesia causes you to lose consciousness. You won’t be awake for the C-section or birth of your baby. Your partner or support person also can’t be in the room during delivery. General anesthesia is rarely used, but may be needed for:

Emergency C-sections.
Medical conditions that make regional anesthesia unsafe.

What to Expect

Regional anesthesia (epidural) is often used during labor to provide pain relief.

If you’ve never had anesthesia before, you may not know what to expect. Most people are pleasantly surprised at how smoothly it goes.

We know that having the lower half of your body numbed can feel strange. Your legs may “fall asleep” or have a “pins and needles” sensation. Some women are upset by this feeling. Try to remember the sensation usually goes away within a few hours after your C-section.

How Regional Anesthesia Is Performed

We use 3 methods to provide regional anesthesia.

Spinal block

A spinal block is the most common type of anesthesia used for a planned C-section. It works within 2 to 5 minutes. It numbs your body from your belly button down.

It’s given like an epidural, but the medicine is injected directly into the spinal fluid. No catheter is placed, so extra medication can’t be given through it. You’ll remain awake during the C-section and delivery of your baby.

In about 2 percent of cases, we need to repeat the spinal block. Again, nothing is wrong, the spinal block just wore off early.

How General Anesthesia Is Performed

General anesthesia is most often used when a C-section is urgent and there isn’t time for an epidural or a spinal block.

We place a breathing tube through your mouth, down your throat, and into your lungs to help you breathe during the procedure. You’ll be asleep during the C-section.

Even if you had a previous C-section, you may have a different experience during another C-section, including the type of anesthesia used.

Because epidurals can be inconsistent and not strong enough for a C-section, general anesthesia might be needed if there isn’t time to replace an epidural that’s wearing off.

How You Prepare

Before a C-section, we’ll talk with you to learn about your medical history. This information helps us identify the best type of anesthesia for your C-section.

For example, we may ask:

When did you last eat or drink?
Do you have a history of problems with anesthesia?
Have you had any lower back problems?
Do you have a family history of rare problems with anesthesia, such as malignant hyperthermia?
Do you have any respiratory conditions, such as asthma, bronchitis, pneumonia?
Do you have any heart or neurological conditions?
Have you recently had a cold or the flu?
Do you take any medications, including herbs and supplements?
Does your unborn baby have any known health issues?

Epidural

An epidural numbs your lower body in about 10 to 30 minutes. You remain awake during delivery.

To have an epidural you will:

Sit up and curl around your belly, making a c-shape with your back.
Get an injection that numbs the skin in your lower back. When numb, a needle and small tube (catheter) are carefully placed into your lower back. The needle is removed, but the catheter stays in position.
Receive anesthesia through the catheter. If a C-section becomes necessary, we can usually inject a stronger concentration of the anesthetic to make you comfortable.

About 15 percent of the time, we must repeat the epidural to keep your lower body completely numb. This doesn’t mean that anything is wrong. Sometimes an epidural just wears off early.

Combined spinal-epidural (CSE) block

This type of anesthesia uses both the spinal and epidural procedures.

Possible Side Effects

Epidural, spinal block, and CSE are generally considered safe for mother and baby.

Common side effects include:

Nausea and vomiting.
Shivering.
Low blood pressure.
Tingling in your bottom and legs when we place the epidural or spinal block that may feel unpleasant.
Temporary back pain or discomfort. This may be at the needle site or from being in an awkward position during labor and delivery.

We monitor and treat low blood pressure as needed, by:

Giving you extra IV fluids.
Tilting your hips and belly to prevent your uterus from squeezing the major blood vessels in your abdomen.
Giving you medicine to increase blood pressure.

Other side effects are rare but may include:

Headache that lasts a few days to a few weeks (spinal headache)
Dizziness
Itching
Ringing in the ears

The headache may be treated with mild pain medicines, fluids, caffeine, and bed rest. In rare cases, other treatment may be needed.

General anesthesia may have a few additional risks that depend on your health and that of your unborn baby. We can talk together about any possible risks.

Before having a planned C-section, follow your doctor’s instructions for enhanced recovery after surgery (ERAS), which may help you recover more quickly.

After Your Procedure

The numbing effects of an epidural, spinal block, or CSE will wear off within a few hours.

As it wears off, you may feel tingling in your legs. Full sensation will slowly return. Your legs may feel a little weak, but you should be able to walk within a few hours after spinal block or epidural anesthesia is stopped.

You may be given a long-acting pain reliever with a spinal or epidural to help control pain in the first 18 to 24 hours after your C-section.

With general anesthesia, you’ll wake up sleepy and groggy. You might have temporary:

Sore throat and dry mouth from the breathing tube.
Nausea.

You’ll be closely monitored until you’re more fully awake.

After having regional or general anesthesia, you may experience shivering. Let us know if you’re uncomfortable. We can give you a medicine through your IV that effectively treats this type of shivering.

When to Call Your Doctor

Complications from anesthesia are rare.

Call your doctor or seek urgent care if you have any of the following symptoms after having anesthesia for a C-section:

Red, tender skin or oozing around the epidural or spinal needle site.
Difficulty breathing.
Painful headache that doesn’t go away.
Numbness or weakness that’s not improving.
Bowel or bladder problems.

Follow your hospital discharge instructions and be sure to call your doctor if you have any concerns.