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Anaesthetic procedure for elective caesarean section (C section)

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Anaesthetic Procedure for Elective Caesarean Section (C-Section)

Introduction to Elective Caesarean Section

An elective caesarean section is a planned surgical procedure to deliver a baby typically performed when vaginal delivery poses risks to the mother or baby. Ensuring adequate anaesthesia is crucial to keeping the mother comfortable and pain-free during the operation.

Types of Anaesthesia

There are primarily three types of anaesthesia used for a C-section: 1. **Spinal Anaesthesia**: This is the most commonly used technique for elective C-sections. It involves injecting a single dose of local anaesthetic into the fluid surrounding the spinal cord, providing numbness from the chest down. 2. **Epidural Anaesthesia**: Often used during labour and can continue through the C-section if required. It involves placing a catheter in the epidural space of the spine, allowing continuous delivery of anaesthetic. 3. **General Anaesthesia**: Reserved for emergency situations or if spinal/epidural anaesthesia is contraindicated. The patient is rendered unconscious during the procedure.

Preoperative Preparation

Before the procedure, the patient will undergo a thorough preoperative assessment. This includes reviewing medical history, current medications, and any potential anaesthetic allergies. Patients are advised to fast for at least six hours prior to the surgery to reduce the risk of aspiration during anaesthesia.

Administration of Anaesthesia

In the operating theatre, an anaesthetist will administer the chosen anaesthetic. For spinal or epidural anaesthesia, the patient will sit or lie on their side while the anaesthetist cleans the spine area and uses a sterile needle to inject the anaesthetic. Patients may experience a tingling sensation as the anaesthetic takes effect, leading to numbness.

Intraoperative Monitoring and Care

Once anaesthesia is administered, the anaesthetist will continuously monitor the patient's vital signs, such as heart rate, blood pressure, and oxygen levels, throughout the procedure. Additional medications can be administered if required, and patient comfort will be a priority.

Postoperative Care and Recovery

After the C-section, the anaesthetist will supervise the initial recovery period, managing pain with medications like NSAIDs or opioids as needed. Patients will be closely monitored for any adverse reactions to the anaesthetic, and support with pain management will continue in the postnatal ward.

Conclusion

Proper anaesthetic management for an elective caesarean section is vital to ensuring the safety and comfort of the mother. Spinal and epidural anaesthesia are preferred due to their effectiveness and minimal impact on the baby. With thorough preoperative assessment and careful monitoring, the anaesthetic procedure can significantly contribute to a positive birthing experience.

Frequently Asked Questions

What types of anaesthesia are used for an elective C section?

The most common types are spinal anaesthesia, epidural anaesthesia, and general anaesthesia. Spinal and epidural anaesthesia are preferred as they allow you to be awake during the procedure.

How does spinal anaesthesia work?

Spinal anaesthesia involves injecting a local anaesthetic into the fluid around your spinal cord, numbing the lower half of your body.

What is the difference between spinal and epidural anaesthesia?

Spinal anaesthesia is a single injection into the spinal fluid, while epidural anaesthesia involves placing a catheter in the epidural space to provide continuous anaesthetic.

Will I be awake during the C section?

Yes, if you receive spinal or epidural anaesthesia, you will be awake but numb from the abdomen down.

Can my partner be present in theatre?

In most cases, your partner can be present if you have spinal or epidural anaesthesia. However, they may not be allowed if you require general anaesthesia.

How long does the anaesthetic take to work?

Spinal anaesthesia works almost immediately, while epidural anaesthesia may take about 10-20 minutes to become fully effective.

Are there any risks associated with spinal or epidural anaesthesia?

While generally safe, there are risks such as low blood pressure, headache, or, rarely, nerve damage.

What should I expect after the anaesthetic is administered?

You will feel numbness in your lower body and possibly some pressure or tugging during the procedure; pain should be minimal or absent.

How long does the numbness last after the C section?

The numbness usually lasts a few hours. You will be monitored as sensation gradually returns.

Will I feel pain during the C section?

You should not feel pain, although you might feel sensations of pressure or tugging.

What happens if the spinal or epidural anaesthesia does not work properly?

If the spinal or epidural anaesthesia is inadequate, additional local anaesthetic may be administered or you might be converted to general anaesthesia.

Can I choose the type of anaesthesia I receive?

Your anaesthetist will discuss the options with you, taking into account medical history and preferences to decide the best choice.

What are the benefits of spinal or epidural anaesthesia over general anaesthesia?

Benefits include being awake to see and hear your baby immediately after birth, fewer risks compared to general anaesthesia, and quicker recovery times.

Can I eat or drink before my C section?

You will be advised to avoid eating and drinking for a certain period before the surgery, usually 6-8 hours for solids and 2-4 hours for clear fluids.

How is pain managed after the surgery?

Post-operative pain is usually managed with medications including paracetamol, NSAIDs, and sometimes opioids. Your anaesthetist will provide a pain management plan.

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