What type of anesthesia is given for a caesarean? Anesthesia for caesarean section - general, spinal, epidural

Future mother, who medical indications there is such a method of childbirth as a caesarean section, she willy-nilly thinks about what kind of anesthesia she should do during this operation.

Among the methods of anesthesia that are used in " caesarean section”, two categories can be distinguished - anesthesia, in which the woman in labor remains conscious (anesthesia), as well as general anesthesia- a method in which the consciousness of a woman is turned off completely. That is, there is no such thing as general anesthesia for a "caesarean section".

Today we will talk specifically about general anesthesia, this is a fairly extensive topic. In the event that you want to learn more about anesthesia, this can be done on our website, in an article dedicated to this topic.

So, what kind of anesthesia is done for a caesarean section? Let's start with the fact that general anesthesia for cesarean section is not at all a frequent practice in modern maternity hospitals. Doctors, as a rule, try to resort to anesthesia in order to keep the expectant mother conscious. But in some cases this measure is necessary. Let's see which ones.

1. First of all, general anesthesia is used for "caesarean section" in the event that the operation is performed in urgent order, and there is simply no time for the complex process of local anesthesia.
2. Such a measure may be necessary if anesthesia is contraindicated for a woman in labor for medical reasons, for example, if there is a focus of inflammation at the site of the procedure.
3. General anesthesia is used in case of oblique or transverse presentation of the fetus
4. In case of morbid obesity in a woman in labor, prolapse of the umbilical cord or accreta of the placenta
5. If the woman has previously undergone spinal surgery
6. Well, in the event that the expectant mother categorically refuses to conduct local anesthesia

Types of anesthesia for caesarean section

Under what anesthesia is a caesarean section performed? There are two ways: intravenous and endotracheal. Let's talk about the pros and cons of each.

(A video of how general anesthesia is performed for a "caesarean section" can be found on our website).

intravenous general anesthesia

This method is performed using an intravenous injection, in which a specially calculated dose of an anesthetic drug is introduced into the body, based on the weight of the patient. As a result, the central nervous system is inhibited, consciousness is turned off and complete relaxation of the muscles occurs.

pros

• Complete, 100% pain relief
• Absolute relaxation of the muscles, which facilitates the work of the doctor
• The speed of conducting, this method will save time when it is really needed
• Does not affect both blood pressure and heart activity
• The anesthesiologist can control both the depth and duration of anesthesia throughout the operation.
• This method is much simpler in technique than, for example, spinal or.

Minuses

• When using this method, the risk of complications for both mother and baby is too high. Intravenous anesthesia is fraught for the child with respiratory failure, as well as disturbances in the work of the central nervous system
• The mother herself may experience hypoxia, as well as involuntary release into the trachea of ​​the contents of the stomach
• If during the operation it was necessary artificial ventilation lungs, the patient's blood pressure may rise. It is also possible that a violation heart rate.

Doctors do not recommend the use intravenous way, and if the choice arises which anesthesia is safer to choose for a "caesarean section", then it is better to stop at the next method, which is somewhat safer, although it also has its own nuances.

Endotracheal general anesthesia

How is general anesthesia done for a caesarean section? Here, a special tube is used to introduce the anesthetic drug into the body, which is inserted into the trachea.

Specialists, in the event that the use of general anesthesia cannot be avoided, stop at this method, since it has a number of significant advantages over the previous one.

pros

• Introduced medicinal product crosses the placenta much more slowly than intravenous administration. Accordingly, the risks for the baby, which we talked about in the previous paragraph, are significantly reduced.
• For future mother the possibility of both cardiac arrhythmias and the work of the cardiovascular system is significantly reduced. After all, the apparatus used to administer this type of anesthesia itself saturates the lungs with oxygen and removes carbon dioxide from them.
• The drug used for anesthesia enters the body in a much more precise amount, and changing its dosage is much easier
• The anesthesiologist can fully control the saturation of the lungs with oxygen, as well as the volume of their ventilation
• When using this method, the contents of the stomach cannot enter the lungs in any way.

But for all obvious advantages endotracheal anesthesia, it, unfortunately, has its drawbacks.

Minuses

• Nausea
• Head and muscle pain
• Severe, up to fainting, dizziness
• Muscle contractions, trembling
• Weakening of consciousness
• Insertion of the tube may cause injury to the mouth and throat
• May cause infection in the lungs
• Allergic and anaphylactic shock
• Damage to the brain and damage to the nerve processes in both the mother and the fetus

If there is a planned time to prepare the woman in labor for it, the woman herself can choose the method of anesthesia, but in most cases it is individually determined by the anesthesiologist. Today, the following methods of anesthesia are used for caesarean section:

Surgical operation on abdominal cavity, due to which the appearance of a child is possible by extracting it from the mother's abdomen, is called a caesarean section. Spend it when natural childbirth are contraindicated and pose a threat to both the health of the mother and the child.

If the caesarean section is planned and there is time to prepare the woman in labor for it, the woman herself can choose the method of anesthesia, but in most cases it is individually determined by the anesthesiologist. Today, the following methods of anesthesia are used for caesarean section:

• spinal;
• general.

When choosing one of them, you should consider the following factors:

• do you want to be unconscious for the duration of the operation and wake up in the ward as a happy mother;
• or you have a desire to “be present” at the operation.

None of the types of anesthesia is desirable for a child, but nevertheless, the greatest risk of complications is associated with general anesthesia, when several medications are injected into the mother's body at once.

Let us consider in more detail each method of anesthesia for caesarean section.

Epidural anesthesia during caesarean section

Anesthesia, in which an anesthetic is injected into the lumbar region of the back (epidural space between the vertebrae) of the expectant mother, is called epidural.

The advantages of epidural anesthesia during caesarean section are, first of all, that the woman in labor is constantly conscious, so that she can observe the birth of her child. Also, due to the fact that the anesthetic (painkiller) gains strength gradually, the stability of the cardiovascular system is maintained. To some extent, even the ability to move is preserved. Epidural anesthesia is indispensable during childbirth, which are accompanied by complications and require a long duration. Only such anesthesia is acceptable for women in labor suffering from bronchial asthma because it does not irritate the airways.

The disadvantages of epidural anesthesia are that the anesthetic may be administered incorrectly or seizures may occur with a large dose.

Epidural anesthesia should only be performed by an experienced specialist, since there is a risk of frequent epidural blocks, which can lead to subsequent frequent severe headaches.

Improper administration of epidural anesthesia is fraught with neurological complications.

Indicators for the use of epidural anesthesia for caesarean section is the risk of changes in the side blood pressure.

Spinal (spinal) anesthesia for caesarean section

The essence of such anesthesia is the introduction of an anesthetic into lumbar back between the vertebrae into the subarachnoid space. When it is carried out, the dense membrane surrounding the spinal cord is pierced (with epidural anesthesia, the needle is inserted a little deeper than with spinal anesthesia).

It is most suitable for caesarean section, among its advantages are the following:

• lack of systemic toxicity;
• excellent analgesic effect;
• the time after the introduction of anesthesia and before the start of the operation is approximately two minutes;
• spinal anesthesia is much easier to introduce than epidural anesthesia, because it very accurately determines the place for inserting a needle.

But also with such anesthesia, there are disadvantages, namely:

• limited time of action (on average, the anesthetic lasts two hours);
• a sharp onset of the action of an anesthetic, which can provoke a decrease in blood pressure;
• as well as with epidural anesthesia, post-puncture headaches may occur;
• the development of neurological complications is possible (in cases where the administered dose of anesthetic was insufficient, repeated injections should not be made. It is necessary either to re-insert the catheter or apply a different method of anesthesia).

spinal anesthesia contraindicated in premature placental abruption.

General anesthesia for caesarean section

This type of anesthesia is used in the diagnosis of fetal hypoxia or in the presence of contraindications for regional (epidural or spinal) anesthesia, among which there may be severe pathologies, increased intracranial pressure or prenatal hemorrhage.

Its essence is that due to drug exposure, the woman in labor experiences a “turn-off of consciousness” and a complete loss of sensitivity.

Virtues general anesthesia with caesarean section, it can be said that it is easier for a woman to tolerate and guarantees complete pain relief if used correctly. It should also be taken into account that anesthesia begins to act very quickly, and this is very important in cases where the operation is urgent and requires immediate implementation. With general anesthesia, the woman in labor is unconscious, and the muscles are completely relaxed, which creates excellent conditions for the surgeon to work.

Also, with general anesthesia, stable work of the cardiovascular system is maintained, since there is no decrease in pressure (as in natural childbirth).

This method of anesthesia is preferred by most anesthesiologists, but it also has disadvantages, namely:

• the development of oxygen deficiency (hypoxia) in a woman;
• there is a risk of impossibility of tracheal intubation (insertion of a disposable plastic tube into it), which, in turn, makes it impossible to connect a woman in labor to the device artificial respiration;
• aspiration may occur (penetration of foreign materials into the respiratory tract, in this case we mean the entry of the contents of the stomach into the lungs of a woman);
• with general anesthesia, depression of the central nervous system of the child is observed, which is associated with the penetration of the narcotic substances used during the procedure through the placenta (this should be especially taken into account in premature pregnancies or if there is too much time between the introduction of general anesthesia and the onset of the birth itself. But you should not panic, since modern doctors use anesthetic drugs with minimal effect on the child's central nervous system - with the right individual selection of drugs, general anesthesia does not threaten with serious consequences).

When is general anesthesia indicated for caesarean section?

Indicators for the use of general anesthesia for caesarean section are:

• threatening condition of the fetus;
• the need for immediate delivery;
• cases when regional anesthesia is contraindicated (for example, the discovery of bleeding in a pregnant woman);
• with the independent refusal of the woman in labor from epidural or spinal anesthesia;
• morbid obesity of the expectant mother.

But it is worth noting the fact that epidural anesthesia is less dangerous for the child than general anesthesia, in which anesthetic drugs are used that act on the brain.

Specially for Anna Zhirko

Cesarean section(CS) is one of the most common operations in obstetric practice, used in complicated pregnancy and childbirth, which allows you to save the health and life of the mother and child. Like any surgical intervention, CS surgery requires anesthesia. The two most common methods are general anesthesia and epidural anesthesia. What determines the choice of anesthesia? What are the advantages and disadvantages of each of them? Let's figure it out.

Epidural anesthesia

Epidural anesthesia is a type of regional anesthesia that allows you to eliminate pain in a certain part of the body. In our case - at - in the lower half of the body.

Methodology

Preparation begins 30-40 minutes before the operation. With a sterile needle at the level of the lower back, a skin puncture is made and through intervertebral discs the needle enters the epidural space. Then the anesthesiologist inserts a soft, thin plastic tube (catheter) through which the medicine (painkillers) will flow, and removes the needle.

information When the drug begins to work, the woman stops feeling lower part body: pain, temperature and tactile sensitivity, approximately from the level of the chest to the tips of the toes. At the same time, the expectant mother retains a clear consciousness: she hears everything, sees everything and can control her condition herself.

Advantages

• The woman remains conscious and is able to independently control her well-being, which allows her, in case of any discomfort, to inform the anesthesiologist about it for them to take measures to eliminate them;
• The relative stability of the cardiovascular system in the mother is maintained, which avoids the additional administration of other drugs;
• The woman in labor breathes on her own, there is no need to intubate the trachea, which means that trauma and irritation of the upper respiratory tract;
• If it is necessary to prolong the operation, an additional dose of the drug can be injected through the left catheter, which will allow it to be stretched for the desired time, and after the operation, add narcotic analgesics to facilitate the postoperative period;
• The overall harm to the child from epidural anesthesia is not great due to the lack of many drugs used in general anesthesia. However, depending on which medicines were used (only anesthetics or also narcotic drugs) some complications are possible: decrease in the heart rate of the child, hypoxia, respiratory failure. With a competent approach of a pediatric neonatologist, all these complications are easily eliminated.

disadvantages

• Epidural anesthesia requires a highly qualified doctor, since the lumen of the epidural space is only 5 mm, it is highly likely to affect the solid meninges, which can subsequently lead to severe headaches (2% of cases);
• At least 20 minutes should elapse from the time of drug administration to the start of the operation, which makes it difficult to use this method in emergency cases;
• Sometimes the catheter may be misplaced, which can lead to unilateral anesthesia and discomfort during surgical procedures. Therefore, before starting the operation, it is imperative to check the sensitivity on both sides and only then proceed to the operation;
• In view of individual characteristics organism, isolated damage is possible nerve root needle or catheter, with the subsequent occurrence of neurological complications (headaches, which in rare cases can drag on for several months).

General anesthesia

In most cases this method anesthesia is used in emergency situations or when epidural anesthesia is not possible (there are contraindications or there is no proper technical support). The woman is unconscious throughout the operation and does not feel anything.

Methodology

General anesthesia for caesarean section is carried out in three stages. First, a "preliminary anesthesia" is administered intravenously to the woman, allowing her to fall asleep, then a tracheal intubation is performed. A tube is inserted into the lower part of the windpipe, through which oxygen and anesthetic gas will subsequently flow. The third stage is the introduction of muscle relaxants, which relax all the muscles of the body, including the uterus. After that, the operation begins.

Advantages

• It does not take much time to enter into anesthesia;
• Easier and most commonly practiced technique;
• Virtually no contraindications for use;
• Creates excellent conditions for the work of surgeons and anesthesiologists;
• The state of the cardiovascular system of a woman during the operation is more stable.

disadvantages

• There is a risk of aspiration of the lungs by gastric contents;
• There may be difficulties with tracheal intubation, its traumatization and, as a result, the occurrence of postoperative period sore throat, cough, respiratory infections, pneumonia;
• A large number of drugs administered during general anesthesia can adversely affect the mother and affect the child;
• Anesthetics and narcotic substances used during anesthesia have a depressing effect on the child's nervous system, expressed in lethargy, lethargy and drowsiness. May also cause breathing problems in the newborn, which may require resuscitation by a neonatologist.

Which anesthesia to choose?

At the stage of preparation for a planned caesarean section, in most cases, the choice between general anesthesia and epidural anesthesia remains with the expectant mother. However, here it is necessary to take into account the equipment of the maternity hospital and the qualifications of specialists.

important In addition, if there are contraindications to epidural anesthesia (acute infectious diseases, injuries and diseases of the spine, bleeding disorders, oblique or transverse position of the fetus), no matter how much you would like to be present at the time of the baby's appearance, for your safety they will not be allowed to do so.

Let's summarize and compare these two types of anesthesia.

Additionally

There is another type of regional anesthesia - spinal. It differs from epidural anesthesia in that the drug is injected into cerebrospinal fluid once, and the catheter is not used. The advantages of this method are easier technical implementation and the ability to use it in emergency cases. However, there is also a drawback: the amount of the administered drug must be strictly and correctly calculated for the operation time, therefore, if unforeseen surgical complications occur and the need to extend the operation time, you will have to switch to general anesthesia.

A caesarean section is a delivery surgically, in which the child is removed through an incision in the mother's uterus. Distinguish between planned caesarean section and emergency. I have gone through two such operations, as a result of which I have two wonderful daughters. I had a planned caesarean section due to myopia high degree. If myopia entails changes in the retina, then a caesarean section is the only way 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

They put me in the hospital a week before giving birth. Here they gave me droppers, gave me vitamins, followed the tests. In general, they prepared for the operation. I gave birth in countryside, so the choice of anesthesia was small, or rather it was not at all. The day before the operation, the anesthesiologist called me for a conversation and warned me that only general anesthesia is done in this hospital. Roughly speaking, they will put me to sleep, and I will wake up already in the ward, becoming a mother. Before the operation, I passed control tests, 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 flattened dissected frog. It was very scary. I was afraid not to fall asleep and feel everything, I was afraid not to wake up at all. The fear of the unknown was scary! Before the start, they gave me oxygen to breathe with the help of a mask, and then anesthesia was introduced into the vein through the 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 around me I’m crushed by an incomprehensible white sticky mass. I hear some kind of growing rumble and I really want to get out of here, but I can’t.

And then I opened my eyes. I came to consciousness badly. felt great weakness, dizzy, pressure dropped to 70/40. I was very thirsty. I didn't feel any pain because I was given painkillers. And I also wanted to know what was happening with the child, how was he. I fully recovered from anesthesia only in the evening.

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

My second epidural birth

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

Summing up summary, I want to say that if you are given the choice of anesthesia, then choose only spinal anesthesia. It is much easier to carry, you are conscious all the time of the operation. You have the opportunity to see the child and be aware of everything that happens. 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 soon as possible. Let it hurt, hard, dizzy, but you have to overcome, force yourself. Otherwise, the seam will heal slowly, and adhesions will still form. Do you need it? As soon as you come to your senses, try not to lie on your back all the time, but turn on one side, then on the other. And after six hours, slowly rise. 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 a little, lie down, rest. I know for myself that I really want to lie down, but I have to overcome myself. It is very important to disperse in the first days. Thanks to this, you will walk without problems already on the third day after the operation. When you breastfeed, you will feel pain in the uterus and increased bleeding. This is fine! When a baby suckles at the breast, uterine contractions occur. Be sure to wear a bandage. With it, there will be no pressure on the seam, and it will heal faster. After discharge, process the seam with brilliant green for five days. I swam on the second day after the operation. After six months, you can go in for sports.

Restoring the shape after a caesarean section is slower, as 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 vision, and I don’t even remember the operations. The seam has long healed and turned pale. Under underwear it is completely invisible. Giving birth through surgery is not scary. The main thing is to think about your baby. Health to you and your children!

In this article:

A caesarean section is performed when childbirth naturally are contraindicated and threaten both the health of the mother and the child. If the caesarean section is planned, there is time to prepare the woman in labor for it. In such cases, sometimes a woman is given the right to choose anesthesia for caesarean section, but often it is determined by the anesthesiologist individually, taking into account the reasons that led to the operation, the type of operation (scheduled, unscheduled), as well as the condition of the woman and her child.

To date, there are several ways of anesthesia during this operation: general, epidural and dorsal. Each type of anesthesia during a caesarean section has its pros and cons. What kind of anesthesia will help to understand this article better, as well as in what cases it is rational to use one or another type of anesthesia.

The nuances of general anesthesia

Today, during delivery, general anesthesia is used only in emergency cases, due to the fact that this species anesthesia has a greater risk than other types of anesthesia, but it requires a minimum amount of time. To begin with, an anesthetic is administered intravenously to a pregnant woman. Literally after a few seconds, when the drug works, a tube is placed in the trachea, providing oxygen and anesthetic gas. And the third part of general anesthesia is my relaxant. This drug relaxes all the muscles of a woman. And only after that the operation itself begins.

Fortunately, there are not so many indications for general anesthesia for caesarean section. But it is not replaceable in the following cases:

• When anesthesia is contraindicated for another type of caesarean section. For example, the discovery of bleeding, morbid obesity, extensive spinal surgery, blood clotting diseases, and others;
• Threatening condition of the fetus. These include prolapse of the umbilical cord, incorrect position of the fetus;
• In case of refusal of the woman in labor from regional anesthesia for caesarean section;
• During an emergency operation, when every minute can be the last.

This type of anesthesia for caesarean section has very few contraindications, but there are plenty of disadvantages that affect both the mother and the child:

• The main risk is the occurrence of aspiration. What does it mean? Gastric juice may enter the lungs, which may cause respiratory failure and pneumonia;
• Since narcotic drugs cross the placenta, depression of the central nervous system of the newborn is possible. Special meaning has in the case of premature birth, as well as in the case when the time between anesthesia and delivery increases. But don't worry too much, because modern drugs for anesthesia, the effect on the fetus is minimal and short. And thanks right action the anesthesiologist will not have serious consequences;
• Hypoxia of a woman. This is due to the high oxygen demand of the pregnant woman;
• There is a risk that tracheal intubation (insertion of a disposable tube into the trachea) becomes impossible for a number of reasons. And connection to the artificial respiration apparatus is not possible;
• An increase in pressure and an increase in heart rate are possible;
• The most common and easiest side effects: muscle pain, nausea, dizziness, cough in the throat, injuries of the lips, teeth and tongue.

In spite of a large number of cons, general anesthesia for caesarean section has a number of advantages:

• rapid descent into an anesthetic state, which is very important condition in threatening cases;
• excellent conditions for the surgeon, due to the complete relaxation of the muscles;
• quite easily tolerated by a pregnant woman, since with correct application pain is completely absent;
• cordially - vascular system works stably and, in comparison with regional anesthesia, there is practically no decrease in pressure;
• anesthesiologists often choose this method of anesthesia. The operating technique used here is more commonly practiced and easier to use.

Epidural pain relief

Often, epidural anesthesia is used in cesarean section operations when it is planned, since in this case preparation time is required. It is not always possible to make a puncture in emergency cases, since an injection is made in a certain place above the spine at the level of the lower back. And to the place where the nerves come out spinal cord in the spinal canal, an anesthetic is injected through a thin, soft tube (catheter). At any time, medication is added through the catheter as needed. The result of anesthesia is a clear consciousness. But all sensitivity below the belt disappears: pain, tactile and temperature. The patient ceases to feel her lower body, cannot move her legs.

Like other types, epidural anesthesia for caesarean section has its own indications and contraindications, advantages and disadvantages.

Indications:

• Premature birth (less than 37 weeks gestation). With this type of anesthesia, muscle relaxation occurs pelvic floor, the fetal head experiences less overload and moves more easily through the birth canal;
• High blood pressure or preeclampsia - epidural anesthesia for cesarean causes a decrease in pressure;
• Discoordination labor activity. At this complication sections of the uterus are contracting varying degrees activity, there is no coordination of contractions between them. This may be due to the high contractile activity of the uterine muscles. The psychological stress of a woman can also lead to this result. Epidural anesthesia for caesarean section slightly weakens the intensity of contractions, inhibits the effect of oxytocin;
• Prolonged childbirth. The lack of complete relaxation for a long period of time leads to anomalies in labor, in which case anesthesia is necessary so that the pregnant woman can rest and recuperate.

Contraindications:

• Violation of blood clotting;
• The close location of the pustules to the puncture site;
• infectious diseases;
• Allergy to the drugs used;
• Severe spinal deformities;
• Scar on the uterus (not always);
• Incorrect position of the fetus (oblique or transverse);
• Large weight of the child, narrow pelvis;
• Refusal of the patient from epidural anesthesia for caesarean section.

The benefits are as follows:

• Clear consciousness of a pregnant woman. There is no risk of intubation or aspiration. A woman is conscious and can enjoy the whole process of the birth of a child;
• No irritation of the upper respiratory tract. For women suffering from bronchial asthma, this anesthesia is preferable;
• The patient the cardiovascular system maintains relative stability, as the anesthetic drug gains strength gradually;
• The relative ability to move is preserved. This is a particularly important condition if the pregnant woman has any muscle pathologies;
• Conducting a long operation. Epidural anesthesia allows you to increase the time of anesthesia, thanks to the catheter, through which repeated supply of anesthetic is possible;
• Anesthesia in the postoperative period. For postoperative pain relief, it is possible to administer special substances called opioids.

Disadvantages of Anesthesia:

• Risk of erroneous intravascular injection. And if an error is not detected in time, convulsions may develop, a sharp decrease in blood pressure;
• Danger of subarachnoid injection. This means injecting an anesthetic under the arachnoid of the spinal cord. It is possible to develop a total spinal block if such an introduction is not detected;
• The epidural anesthesia procedure is more complicated than other types of anesthesia;
• It is possible to start the operation after a certain period of time, since it takes 10-20 minutes before the onset of anesthesia;
• There is a possibility of inadequate pain relief. Sometimes the cranial nerves are not blocked and there is discomfort during the operation;
• Some epidural drugs cross the placenta. This can lead to a decrease in the heart rate of the child, a violation of the breathing of the newborn;
• There may be discomfort after surgery: back pain, headache, trembling in the legs, urination disorders.

But you should not worry too much, because the experience and vigilance of an anesthesiologist and a pediatric neonatologist will help to avoid serious complications.

Spinal anesthesia during surgery

Spinal anesthesia for caesarean section is similar to the previous type of anesthesia, but unlike epidural anesthesia, the needle is inserted a little deeper, since a puncture of the dense membrane surrounding the spinal cord in the lumbar region of the back between the vertebrae is required.

This type of anesthesia is also called spinal anesthesia. The puncture is performed between the 2nd and 3rd, or 3rd and 4th lumbar vertebrae, because the spinal cord ends here, and there is no danger of damaging it. Despite the fact that this anesthesia is performed in the same place as the epidural, a thinner needle is used. The dose of the drug is smaller and it is injected below the level of the spinal cord into the space containing the cerebrospinal fluid.

This type of anesthesia also has its contraindications.:

• Skin infection at the site where the puncture is to be made
• If the patient's blood coagulation function is impaired, as well as circulatory disorders;
• Sepsis;
• Certain forms of neurological disease;
• In the case of existing diseases of the spine, in which it is impossible to perform a puncture;
• Mother's refusal.

This type of regional anesthesia has significant advantages.:

• At correct introduction anesthesia achieves complete anesthesia;
• The possibility of an urgent operation, preparation for the operation can begin after a couple of minutes from the time of administration of the anesthetic drug;
• The procedure for performing spinal anesthesia is quite simple compared to epidural, due to the fact that you can accurately determine the puncture site;
• In the case of improper intravascular administration of the anesthetic, toxic reactions do not occur;
• Cheaper than other types of anesthesia used for caesarean section.

But there are also disadvantages:

• The duration of action is limited (about 2 hours), although this period of time is sufficient for the operation;
• Due to the rapid onset of action of the drug, there is a risk of lowering blood pressure. With the right preventive measures, this can be avoided;
• A post-puncture headache in the frontotemporal region is likely for 1 to 3 days. But again, it depends on the experience of the doctor.

Which anesthesia is preferable

There is no such type of anesthesia that would not have contraindications and disadvantages. Absolutely every anesthesia listed above has both pros and cons. But after analyzing the above about anesthesia during cesarean section, we can conclude that the most the best option is spinal anesthesia.

It would not be superfluous to add that the material in this article is only for general development. In no case should you use the knowledge gained during childbirth, as well as arguing with anesthesiologists after surgery. After all, always when choosing a method of anesthesia, adjustments are made to the current situation.

Video show about caesarean section