If the cesarean section is planned and there is time for the preparation of the parturient woman to it, the woman herself can choose the method of anesthesia, but in most cases it is individually determined by the anesthesiologist. Today, these methods of anesthesia are used in cesarean section:
Surgical operation on the abdominal cavity, due to which the appearance of a child by extraction from the abdomen of the mother is possible, is called Caesarean section. Conduct it when natural births are contraindicated and carry a threat to both the health of the mother and the child.
If the caesarean section is planned and there is time to prepare a woman in labor for it, the woman herself can choose the method of anesthesia, but in most cases the anesthesiologist individually determines it. Today, these methods of anesthesia are used in cesarean section:
Choosing one of them, you should consider the following factors:
- whether you want to be unconscious for the duration of the operation and already wake up in the ward with a happy mother ;
- Or you have the desire & ldquo; Attending & rdquo; during the operation.
No type of anesthesia is desirable for a child, but the greatest risk of complications is associated with general anesthesia, when several medications are administered to the mother's body.
Let's consider in more detail each method of anesthesia in cesarean section.
Epidural anesthesia during cesarean section
Anesthesia, at which an anesthetic is introduced into the lumbar region of the back (epidural space between the vertebrae) of the future mother, called epidural.
The advantages of epidural anesthesia in conducting a cesarean section is primarily that the mother is constantly in consciousness, so she can observe the birth of her child. Also, due to the fact that the anesthetic (anesthetic) is gaining strength gradually, the stability of the cardiovascular system is maintained. To some extent, even the ability to move. Indispensable epidural anesthesia in childbirth, which go with complications and require a long duration. Only such anesthesia is permissible for mothers suffering from bronchial asthma, because with her the airways are not irritated.
The disadvantages of epidural anesthesia is that it is possible that the anesthetic is not injected correctly or if seizures occur at a large dose.
Epidural anesthesia should be performed only by an experienced professional, since there is a risk of frequent epidural blockages, which can lead to subsequent frequent severe headaches.
Incorrect injection of epidural anesthesia is fraught with neurological complications.
Indicators for the use of epidural anesthesia in cesarean section is the risk of changes in the blood pressure.
Spinal (spinal) anesthesia with caesarean section
The essence of this anesthesia is the introduction of an anesthetic into the lumbar spine between the vertebrae in the subarachnoid space. When it is carried out, a dense shell surrounding the spinal cord is pierced (with epidural anesthesia the needle is inserted a little deeper than with the spinal cord).
Spinal anesthesia is most suitable for cesarean section, among its advantages are the following:
- absence of systemic toxicity;
- An excellent analgesic effect;
- time after the introduction of anesthesia and before the commencement of the operation is approximately two minutes;
- spinal anesthesia is much easier to enter than epidural, because with it the place for insertion of the needle is very accurately determined.
But also with such anesthesia, there are shortcomings, namely:
- limited duration of action (on average, the anesthetic is valid for two hours);
- the sharp onset of the action of an anesthetic, which can provoke a decrease in blood pressure;
- Also, as with epidural anesthesia, there may be post-puncture headaches;
- neurological complications may develop (in cases where the injected dose of anesthetic has not been sufficient, repeated injections can not be done.) It is necessary to re-enter the catheter or apply another method of anesthesia.
Spinal anesthesia is contraindicated in premature placental abruption.
Conduction of general anesthesia for cesarean section
This type of anesthesia is used in the diagnosis of hypoxia in the fetus 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 lies in the fact that due to medical effects in the parturient woman there is a "disconnection of consciousness" and a complete loss of sensitivity.
Advantages of general anesthesia in Caesarean section can be called that it is more easily tolerated by a woman and guarantees complete anesthesia with proper application. It should also be taken into account that anesthesia very quickly begins to act, and this is very important in cases where the operation is urgent and requires immediate implementation. With general anesthesia, the mother does not have consciousness, and the muscles are completely relaxed, which creates excellent conditions for the surgeon's work.
Also, with a general anesthesia, the cardiovascular system remains stable, as there is no decrease in pressure (as in natural childbirth).
This method of anesthesia is preferred by most anesthetists, but it also has disadvantages, namely:
- the development of oxygen deficiency (hypoxia) in a woman;
- there is a risk of impossibility of intubation of the trachea (introduction of a disposable plastic tube into it), which, in turn, makes it impossible to connect the mother to the respirator;
- possibly the emergence of aspiration (penetration of foreign materials in the respiratory tract, in this case, meaning the entry of stomach contents into the lungs of women);
- In general anesthesia, the central nervous system of the child is depressed, which is due to the penetration of drugs through the placenta used in the procedure (this should be especially taken into account in premature pregnancies or when there is too much time between the introduction of general anesthesia and the onset However, it is not necessary to panic, since modern physicians use anesthetics with minimal effect on the child's CNS - with the correct individual selection of drugs, general anesthesia does not threaten with serious consequences).
When is the general anesthetic shown in the caesarean section?
The indicators for the use of general anesthesia for caesarean section are:
- Fetal threatening state;
- the need for immediate delivery;
- cases where regional anesthesia is contraindicated (for example, the opening of a bleeding in a pregnant woman);
- if the mother gives herself up alone from epidural or spinal anesthesia;
- pathological obesity of the future 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.