Consequences of epidural anesthesia. C-section with epidural as a happy moment

During operative delivery, the child is removed through an incision in the uterus and abdominal wall. This method is called a caesarean section. According to statistics in our country, every 8 woman has indications for its implementation. There are several methods of anesthesia performed before the procedure. So, anesthesia for caesarean section can be spinal, epidural, general intravenous and endotracheal.

When choosing a method of anesthesia, several factors are taken into account: the desire of the woman in labor, the availability of the necessary equipment and staff in the maternity hospital. It also takes into account the health of the woman, especially the course of pregnancy and the birth itself (planned or emergency caesarean section).

Epidural anesthesia for caesarean section is used during elective operations, since its result appears gradually, after 15-30 minutes. The main mechanism of the procedure is that the sensitivity of the nerve roots in the epidural space of the spine is blocked by an anesthetic.

The procedure is often performed in a sitting position, less often - lying on its side. First, the doctor determines the injection site, then the assistant treats the injection area with a sterile solution. After that, local anesthesia (shot) is applied for painless administration of epidural anesthesia. The doctor draws a sterile solution into one syringe, and an anesthetic into the other.

A special needle with a diameter of 2 mm and a length of about 9 mm is inserted into the intervertebral region. A sterile solution is used to determine when it enters the epidural space. Then a thin tube is inserted into the needle - a catheter, through which the anesthetic is supplied from the second syringe. The needle is removed, the drug supply is completed after the end of the operation.

Epidural anesthesia for caesarean section is indicated if the woman in labor has:

heart or kidney disease;
preeclampsia;
diabetes;
arterial hypertension;
other health problems requiring gentle anesthesia.

Also, this method is used if childbirth began naturally and an anesthetic was already introduced into the epidural space, but then emergency surgical intervention was required.

Epidural anesthesia is not performed if the woman in labor refuses it herself, there is no specialist, equipment or materials for the procedure in the maternity hospital.

This type of anesthesia is contraindicated for women suffering from low blood pressure and insufficient blood clotting, as well as for those who have injuries, curvature and other pathologies of the spine. It is impossible to perform epidural anesthesia in case of inflammatory, including infectious, processes at the site of the proposed puncture. Another reason for refusing this type of anesthesia can be oxygen starvation of the fetus.

If a woman undergoes a caesarean section, anesthesia is one of the sources of complications. After epidural anesthesia, trembling in the muscles of the legs, back pain and headache may appear. The latter sometimes lasts up to several months. The consequences for the child are associated with the effect of the anesthetic: possible violation of the heart rhythm and breathing, hypoxia.

All complications are usually manageable. At the same time, epidural anesthesia provides effective pain relief, is safe for the child (compared to other methods), lowers blood pressure, and, therefore, reduces the risk of significant blood loss. The recovery period after such anesthesia is quite short, during the operation it is possible to control the supply of anesthetic.

Among the shortcomings, one can note the complexity of the procedure - a lot depends on the experience of the anesthesiologist, his qualifications. An incorrect puncture can lead to anesthesia of only one half of the body, to infection, toxic poisoning with respiratory arrest and death.

Because the anesthetic begins to work slowly and gradually lowers the woman's blood pressure, the child experiences oxygen starvation. The same feature does not allow the use of epidural anesthesia in emergency cases.

Spinal anesthesia for caesarean section

Spinal anesthesia is performed during planned and emergency surgery, when there is at least 10 minutes left. The steps of the procedure are almost the same as for epidural anesthesia, but the anesthetic is injected into the cerebrospinal fluid and only with a needle (no catheter is used).

Which anesthesia will be chosen for caesarean section is determined by the list of indications and contraindications. Spinal anesthesia is recommended in the same situations as epidural, but due to its instant action, it can be used in emergency operations.

Spinal anesthesia for caesarean section is not performed if the woman refuses this method of anesthesia or there is no appropriate specialist, drugs, equipment for resuscitation in case of complications.

Contraindications:

dehydration;
bleeding;
poor blood clotting, including due to taking anticoagulants;
infections and inflammations (local at the puncture site, general);
allergic reactions to drugs for the procedure;
disorders of the heart and central nervous system;
high intracranial pressure;
on the part of the fetus - a state of hypoxia.

After spinal anesthesia, like any other anesthesia, complications may develop. Most often the rest are manifested:

back and headaches;
lowering blood pressure;
difficulty urinating;
muscle weakness;
decreased sensitivity.

Spinal anesthesia has many advantages, the main of which are the absence of the effect of drugs on the child, a quick result, complete pain relief and muscle relaxation, and a low risk of developing respiratory disorders in a woman in labor. The dose of anesthetic agents is less than with epidural anesthesia, which means that their negative effects are less pronounced.

The procedure itself is simpler, requires less effort from the anesthesiologist, which improves the quality of pain relief and minimizes the risk of complications.

The disadvantages of the method include: a rapid decrease in blood pressure and the difficulty of normalizing it due to the effect of drugs on the child, the inability to prolong the effect of the anesthetic during the operation (in an emergency - transfer to general anesthesia), a high probability of neurological complications, especially headaches.

Cesarean section under general anesthesia

General anesthesia for caesarean section is often used in emergencies. Its essence lies in the fact that pain relief occurs due to the intravenous administration of anesthetics or the use of an anesthetic mask. In this case, the mother is in a state of sleep. The duration of the procedure depends on the dose and type of drug, it can be from 10 to 70 minutes.

Cesarean section under general anesthesia is indicated if the operation is performed on an emergency basis and there is a threat to the life of the woman in labor or the fetus, spinal and epidural anesthesia are contraindicated, placental accreta, oblique or transverse position of the fetus are detected. This type of anesthesia has practically no contraindications. If possible, it should not be used in acute diseases of the cardiovascular and respiratory systems.

After general intravenous anesthesia, the risk of developing such complications is quite high:

headache;
dizziness;
short-term disorientation in space and time;
confusion;
muscle pain.

It is also possible to suppress brain functions due to the effects of drugs. This type of anesthesia does more harm to the child than the previous two. The drugs have a toxic effect on the central nervous system, respiratory disorders, lethargy may appear.

Caesarean section under general anesthesia also has positive aspects: anesthesia is always complete, the muscles are relaxed, the surgeon has the opportunity to carry out all the necessary manipulations.

The drugs act very quickly, while the work of the heart and blood vessels is not inhibited. If necessary, anesthesia can be strengthened and extended.

General anesthesia faster than other methods leads to hypoxia in the woman in labor. When artificial lung ventilation is connected, an increase in pressure and an increase in heart rate are sometimes noted.

Drugs administered intravenously have a significant impact on the functioning of the child's nervous system. This negatively affects his condition, especially with premature pregnancy, hypoxia and malformations.

Endotracheal anesthesia for caesarean section

With endotracheal anesthesia, an intravenous infusion of a drug is first performed that turns off the consciousness of the woman in labor, and then a tube connected to a ventilator is inserted into the trachea. In addition to oxygen, an inhalation anesthetic is supplied through it, which blocks pain and introduces a woman into a deeper sleep.

Often the method is used together with intravenous general anesthesia. This allows you to increase the duration of the procedure and control breathing.

Endotracheal anesthesia is indicated for emergency operations, the presence of contraindications to other methods of anesthesia, a sharp deterioration in the condition of the mother or fetus. The planned method is used when it is known in advance that the caesarean section will be long, with a large number of additional surgical procedures.

The procedure of endotracheal anesthesia is absolutely contraindicated in acute and subacute inflammatory processes of the upper respiratory tract, bronchitis, pneumonia, hemorrhagic diathesis, acute and chronic infectious diseases (for example, tuberculosis of the larynx and lungs). In some heart conditions, if possible, this type of anesthesia is abandoned in favor of another.

A caesarean section is designed to remove the baby from the abdominal cavity without risk to health, if for some reason the woman cannot give birth naturally. The date of caesarean section is usually appointed in advance, they prepare for this operation, including choosing anesthesia.

If anesthesia for caesarean section has already been chosen by the woman in labor or the doctor, then you should know how it will be carried out, what are the pros and cons of each type of anesthesia and whether it will affect the child.

The most popular are three types of anesthesia for caesarean section: spinal, epidural and general anesthesia.

Spinal anesthesia is a type of local anesthesia that is performed by injecting an anesthetic into the spinal space, causing loss of sensation in the lower body.

In most cases, spinal anesthesia for caesarean section is used in emergency situations requiring immediate surgical intervention. Spinal anesthesia for caesarean section works quickly. Within a few minutes, the lower half of the body becomes numb in the woman in labor. At the same time, the woman herself remains conscious and can help doctors monitor her condition.

How is Spinal Anesthesia Performed for a Cesarean Section?

The most popular initial position for drug administration is the fetal position, when the woman lies on her side and pulls her bent knees to her chest as much as possible. This position gives doctors good access to the spine. The second option for the required position is sitting, hands on knees, back arched by the wheel. Anesthesiologists prefer the first option, because when the sensation of the lower body is lost under the influence of the medicine, it will be easier for the woman in labor to lie on her side to roll over on her back.

Then comes the first injection of anesthesia. There will be two injections, because the second is incredibly painful, and the woman in labor does not need to experience additional stress. The first shot acts on a small area. Thanks to the first injection, the skin and tissues under it lose their sensitivity to pain, and the second needle can pass freely without causing discomfort.

The next step is a kind of puncture. Only the cerebrospinal fluid is not taken for analysis, as with a conventional puncture, but a second medication is injected there - an anesthetic. This fluid is located between the vertebrae and provides instant pain relief.

After the injections, the puncture site is covered with a napkin and fixed. The woman in labor ceases to feel not only pain, but also other touches.

If you have never experienced the effects of anesthesia, your own hand will help you understand what it is. Lie on your side and rest your head on your outstretched arm. After a short time, the arm will become numb and feel like someone else's - about the same effect will cover your body below the back during surgery.

Video: How spinal anesthesia is done

Who gets spinal anesthesia for a caesarean section?

In addition to the personal choice of the patient, there are a number of indications that, with a high degree of probability, can lead obstetricians to decide to use spinal anesthesia for cesarean delivery. These include:

a situation that poses a threat to the life of the fetus or mother, requiring immediate intervention. If it is possible to do general anesthesia, they will most likely do it, but there are cases when it is contraindicated;
if natural childbirth began, the woman was given epidural anesthesia, but something went wrong and it is necessary to complete the process by caesarean section;
syndrome of late toxicosis of pregnant women (preeclampsia);
heart disease;
diabetes;
chronically high blood pressure;
kidney dysfunction.

Who should not have spinal anesthesia for a caesarean section?

Spinal anesthesia contains a number of contraindications, the presence of at least one of which can lead to consequences up to lethal:

allergy to the anesthetic used (before the operation it is necessary to make samples);
strong pressure inside the skull;
fetal hypoxia
diseases of the central nervous system;
exacerbated infections (any, even herpes);
severe blood loss;
the use of blood clotting drugs before surgery;
the absence of any component of the necessary set of drugs and equipment for spinal anesthesia, or a sufficiently qualified anesthesiologist.

You can also refuse this type of anesthesia. A written and certified by the patient refusal cannot be violated.

Benefits of Spinal Anesthesia

Spinal anesthesia for caesarean section has a number of positive aspects. This type of anesthesia does not affect the child's body in any way. The drugs simply do not reach the baby, so they do not work on him.

The woman in labor remains conscious during the caesarean section, which allows the doctor to monitor her condition.
Spinal anesthesia for caesarean section relieves pain within minutes and is thus widely used during emergency childbirth.
With a probability of 100% it anesthetizes the entire lower part of the body. The action of the anesthetic after the injection lasts 1-4 hours (depending on the drug chosen)
The abdominal cavity can be prepared for surgery as early as 2 minutes after the administration of the anesthetic.
Spinal anesthesia for caesarean section has an easier injection technique compared to epidural or general anesthesia.
The injection uses a thinner needle to administer the anesthetic compared to epidural anesthesia
The effect on the child in rare cases is about 4 ml of the injected anesthetic. In most cases, the anesthetic has no effect on the child.
Spinal anesthesia for caesarean section does not have a toxic effect on the central nervous system or the cardiovascular system (since this effect is possible with epidural anesthesia)
Spinal anesthesia for caesarean section allows the muscles to completely relax, which helps create a comfortable environment for the caesarean section.

Disadvantages of Spinal Anesthesia

Each type of anesthesia has this item, because there is always a risk of complications in working with drugs.

The drug is administered once. Adding a dose is not recommended. At the same time, no doctor will be able to preliminarily determine how long the operation will last. And if something does not go according to plan, the anesthetic will expire, but the operation will not. This does not mean that the caesarean section will be completed "on the live." The woman will simply be transferred to general anesthesia, but this procedure is also fraught with risks, and in this case, the woman in labor will not hear the first cry of the baby.
neurological complications. Among the most common complications of spinal anesthesia after cesarean are headaches, which may not go away for weeks or even months.
Decreased blood pressure in the mother. Although there is no direct effect of drugs on the baby's body, the consequences of maternal anesthesia can still affect it. In particular, this is due to blood pressure, which drops after the injection of an anesthetic. Low blood pressure can cause hypoxia in the fetus. Usually, the blood pressure of a woman in labor is raised with the help of special drugs. Just these drugs can cause high blood pressure in a child. In turn, this is reflected in his nervous system.

Epidural anesthesia for caesarean section

Epidural anesthesia is a type of local anesthesia that is performed by injecting an anesthetic into the epidural space, causing loss of sensation in the lower body.

The difference between epidural anesthesia and spinal anesthesia lies in the anatomical spaces of the spinal region, where painkillers are injected. It should also be noted that the mechanism of action of the painkiller is also different. Spinal anesthesia has a limited duration of action, while epidural anesthesia can operate indefinitely due to the catheter that is inserted into the woman in labor.

How is epidural anesthesia done for a caesarean section?

The first injection is made in the same way as in the case of spinal anesthesia - in order to anesthetize the tissues in the area of \u200b\u200bthe main injection. The desired place is wiped with an alcoholized cotton swab and an almost painless injection is made. The injected drug begins to act instantly, and you can feel how a small area of \u200b\u200bthe body goes numb.

The second needle is inserted into the space between the spine and the spinal cord, where the nerve endings are located. It is on them that epidural anesthesia should act, blocking the passage of signals to the brain. The anesthetic is not able to distinguish between pain and other signals, therefore it blocks everything: the woman will also not feel the touch.

Then a catheter is passed through the needle. It penetrates under the skin, ends with the end of the needle and is securely fixed there. The needle is gradually withdrawn, but the catheter remains. Now, through it, new doses of anesthetic can be supplied to the woman's body. The medicines begin to act about half an hour after the second injection.

Video: Emergency caesarean section. Epidural anesthesia for caesarean section.

Who should not have an epidural for a caesarean section?

A number of prohibitions largely coincide with spinal anesthesia, as a result of which a consultation with a doctor is necessary before the final choice. Epidural anesthesia for caesarean section is definitely prohibited for those who:

there are spinal injuries - both at the moment and previously transferred;
chronically low blood pressure;
the risk or initial development of hypoxia in a child;
suspected bleeding, or existing bleeding.

Benefits of epidural anesthesia

A more complex method does not always mean a better one. But this anesthesia has a number of advantages:

The woman is also conscious, can control her breathing and hear the first cry of her baby.
Blood pressure is reduced gradually, which allows doctors to better control it.
If the operation is delayed for any reason, anesthesia can be extended without transferring the woman in labor to general anesthesia.

Disadvantages of epidural anesthesia

For a doctor, it is quite difficult. And if he performs any element of manipulation incorrectly, this may affect the course of the operation.
It is easier for a needle to break through the wrong wall and inject drugs into the blood. If the epidural anesthetic enters the bloodstream, it is not immediately possible to notice and localize this problem. That is, for some time the medicine will not go there. This is fraught with poisoning up to death.
Another consequence of a broken “wrong wall” is a spinal block. It can stop the heart.
While the epidural anesthesia for caesarean section begins to work, the falling-rising pressure of the mother can cause hypoxia in the child.
This type of anesthesia may not work at all, or it may anesthetize only one part of the body. Such a result cannot be predicted.
It is possible for cerebrospinal fluid to seep into places where it shouldn't be. Anesthesia after a caesarean section will end, but the pain in the head and back will remain, and for a long time.

Until the anesthesia is over, make sure that you are placed on the bed correctly - the legs should not buckle or lie unnaturally.

The effect of epidural anesthesia on a child

Drugs, getting into the body of a woman, also have an effect on the body of the child. Depending on the type of painkiller, the effects may be different. As a rule, they are the following:

the baby's heartbeat becomes ragged or too slow;
the occurrence of fetal hypoxia;
abnormal breathing after birth, sometimes this requires mechanical ventilation.

General anesthesia for caesarean section

General anesthesia for caesarean section is the best type of anesthesia for some women in labor. It should be noted that general anesthesia is the most difficult type of anesthesia.

How is general anesthesia done for a caesarean section?

The woman is given an anesthetic injection, then an oxygen tube is placed to keep her lungs ventilated while the woman is under anesthesia. The drug begins to act literally at the moment it enters the bloodstream, after which the woman in labor enters a state of sleep. Pain sensitivity disappears, the injected drug affects muscle relaxation, reduces and disables some reflexes.

Who is given general anesthesia for a caesarean section?

As a rule, general anesthesia for caesarean section is indicated for those women in labor who cannot be given other types of anesthesia, and caesarean section should be performed. But there are other options:

threat to the life of a child or mother;
if there is a possibility of complications in the uterus or severe bleeding;
if the woman in labor is overweight;
with bleeding.

If a woman in labor wishes to perform general anesthesia for a caesarean section, then first of all, credit should be given in choosing a good anesthesiologist. The wrong dose of anesthesia during the operation can lead to unpredictable consequences.

Benefits of General Anesthesia

Works instantly.
Does not affect blood pressure in any way. Therefore, if the baby is not predisposed to hypoxia, he will not begin to choke during a cesarean section.
All muscles are relaxed, the surgeon can work calmly. The same effect is achieved with other types of anesthesia, but in them there is a risk of insufficient exposure or preliminary termination. In addition, even without feeling her own muscles, the woman in labor can strain them, because during spinal and epidural anesthesia the brain is conscious.
Many women are afraid of the sight of blood. Of course, with other types of anesthesia, the patient does not see the process of caesarean section: at chest level, doctors always put a screen covering the view. But not every psyche is able to calmly endure the realization that living flesh is being cut with a scalpel. To get rid of unpleasant psychological sensations and experiences on the topic “what if something goes wrong”, some women prefer complete deprivation of consciousness.

Disadvantages of general anesthesia

Nausea, headache and clouded mind can accompany a woman for several hours after waking up, or for several days. It depends on the individual characteristics of the organism.
Coughing after surgery is painful. But, most likely, it will be necessary, because a tracheal tube is put in labor, and it can irritate the airways.
Even in a semi-conscious state, a woman retains a gag reflex. When the tracheal tube is inserted, the stomach may expel the contents. Life-threatening aspiration will occur.

There is no need to listen to those who claim that the bond between mother and child will be somehow broken if the mother does not hear his first cry. You carried the baby for nine months. A few hours of his being outside the womb will not solve anything. As soon as you wake up, the baby will be brought in for feeding, and your bond with him will be as strong as during pregnancy. So there is nothing terrible or cowardly in the choice of general anesthesia. After all, a very nervous woman in labor can even harm the process.

The effect of general anesthesia on a child

Anesthetics injected into the mother's blood can enter the baby's blood through the placenta. Now more and more new types of anesthesia are being developed, but they all still affect the baby. In particular:

after birth, the child is lethargic, may not scream in the first seconds. The anesthetic affected the general activity of his body, dampening it a bit;
there may be consequences that appear even after a few years. It depends on the type and dose of drugs administered to the mother, as well as on the duration of the caesarean section.

Summing up

Each type of anesthesia has its advantages and disadvantages. What kind of anesthesia to choose for a caesarean section, the pregnant woman decides subjectively, the doctor helps her objectively, depending on the individual characteristics and possible deviations during the bearing of the child. Factors influencing the successful implementation of anesthesia depends on the correct choice of anesthetic, the type of anesthesia itself, as well as on the professionalism of doctors and the availability of appropriate conditions for this event.

Choosing a method of anesthesia, a pregnant woman may be guided by personal preferences. Also, a future woman in labor can write a refusal to conduct one or another anesthesia. The doctor chooses the type of anesthesia and can justify his choice, predicting the possible consequences depending on your current condition. By refusing the offered type of pain relief and choosing your own, you expose yourself to the possibility of risks during the caesarean section. Remember about your health and the health of your unborn baby.

The method of anesthesia for caesarean section is determined by the anesthetist individually for each woman in labor and depends on the reason that led to the operation, on the condition of the pregnant woman and the fetus, as well as on the type of operation: planned or emergency caesarean section.

Epidural anesthesia

During caesarean section, the following anesthesia techniques can be used:

. With this method, only the lower half of the body, including the operation site, is anesthetized.
General anesthesia(endotracheal anesthesia).

Epidural anesthesia for caesarean section

Epidural anesthesia during childbirth is one of the most effective methods, but it is technically more difficult than spinal anesthesia and requires special equipment and a certain qualification of the anesthetist. Epidural anesthesia is performed for pain relief in both conventional childbirth and caesarean section.

Epidural anesthesia is usually performed with the woman in labor sitting up straight or lying on her side, curled up to give the anesthesiologist optimal access to the spine. If the trial dose is successful, then a catheter is usually left in the epidural space, through which the drug is added as needed, the dose of which is varied as needed.

Indications for epidural anesthesia: preeclampsia - improves renal and placental blood flow; with pathology of the cardiovascular system (reduces the load on the heart and reduces the risk of complications), emergency caesarean section with a full stomach, etc.

Contraindications for epidural anesthesia in childbirth do not differ from general contraindications: low blood pressure, risk of blood loss, use of anticoagulants, inflammatory reactions at the puncture site, patient refusal, severe spinal deformities, lesions of the central nervous system.

Possible complications with epidural anesthesia: headache, back pain, arterial hypotension, respiratory failure, bladder dysfunction, allergies, etc.

Spinal (spinal) anesthesia for caesarean section

In most cases, when performing a planned caesarean section, anesthesiologists choose spinal anesthesia. At the same time, the woman in labor is in an awake state, which ensures the safety of the respiratory tract, the child is born in good condition. Spinal anesthesia is also indicated for urgent need for a caesarean section.

The technique can be used even with little experience on the part of the anesthesiologist; anesthesia comes on quickly and provides good conditions for the operating surgeon.

Spinal anesthesia is performed in the same place as epidural, but with some differences: a thinner needle is used, the dose of anesthetic for the spinal block is much less, and it is injected below the level of the spinal cord into the space containing cerebrospinal fluid.

The spinal block is carried out in the position of a woman sitting or on her side. If a woman sits on the edge of the operating table, then her feet are on a stand, and her body leans forward and she rests her elbows on her knees. The procedure can also be performed with the woman lying on her left side with her hips and knees maximally bent. In any case, it is necessary to achieve maximum flexion of the back.

A small area of the back is treated with an antiseptic solution, then a spinal anesthesia needle is inserted into the space between the two vertebrae. A few minutes after the injection of the drug, a blockade of nerve fibers occurs in the lower body, the woman in labor begins to feel warm, numbness gradually occurs, sensitivity decreases, the muscles of the lower extremities relax, and the surgeon can start the operation in 5-7 minutes.

After the introduction of a local anesthetic is completed, a sterile gauze cloth is applied to the puncture site, which is fixed with an adhesive plaster. A woman in labor is never allowed to lie on her back, as in this position the uterus compresses the vena cava, causing hypotension (lowering blood pressure). Therefore, the woman lies on her side, this is achieved either by tilting the operating table or by inserting a roller under the right side. The uterus is shifted slightly to the left and the vena cava is not compressed. During the operation, under spinal anesthesia, women in labor are given an oxygen mask.

As a rule, with spinal anesthesia, the quality of pain relief is so high that the woman does not even realize that she is being operated on, but if discomfort occurs, which rarely happens, anesthesia will immediately be supplemented with the introduction of powerful intravenous analgesics or the woman will be transferred to general anesthesia.

Depending on the drug chosen, the blockade can last from one to three hours. After recovering from anesthesia, not very pleasant sensations are possible - severe chills.

Advantages of spinal anesthesia over epidural anesthesia for caesarean section.

The effect develops within a few minutes: suitable for most urgent operations.
The quality of anesthesia is higher than with epidural anesthesia, and incomplete anesthesia is less common.
Spinal anesthesia is technically easier, therefore, reduces the number of unsuccessful attempts and complications.
Smaller doses of local anesthetics several times reduces the risk of toxic reactions.
There is no such formidable complication of epidural anesthesia as a total spinal block with an unintentional puncture of the dura mater.
Much cheaper than general and epidural anesthesia.

Benefits of spinal anesthesia over general anesthesia for caesarean section

The woman in labor is conscious when the baby is born, she can hear the first cry of the baby, take him in her arms, in some maternity hospitals they are allowed to attach to the breast immediately after processing the umbilical cord, which contributes to earlier lactation and effective uterine contraction.
After general anesthesia, the initial recovery period lasts several hours, during which the woman may be in a lethargic (half-asleep) state, and after spinal anesthesia, the woman remains active and, upon arrival in the recovery room, for example, can report joyful news by phone or take care of the child.
Mortality with spinal anesthesia is several times lower than with general anesthesia, since there are no problems of difficult intubation (introduction of a special tube into the larynx through the mouth in order to eliminate respiratory failure), a full stomach, etc.

Contraindications for spinal anesthesia

Patient refusal.
Lack of conditions, if there are no means for resuscitation at hand (no monitoring, necessary medicines, insufficiently qualified personnel).
Blood loss, dehydration.
Violation of blood clotting, otherwise severe hypotension may develop.
Treatment with anticoagulants (heparin, warfarin).
Sepsis.
Skin infection at the puncture site.
Increased intracranial pressure.
Allergic reaction to local anesthetics.
Bradycardia, cardiac arrhythmias.
Distress, fetal hypoxia.
Exacerbation of herpetic infection.
Diseases of the central nervous system

Urgency, lack of time.
Fetal malformations, fetal death.
Heart defects, decompensation of cardiac activity.

Possible Complications of Spinal Anesthesia

After spinal anesthesia, a characteristic headache may occur, which may increase when standing up or when lifting the head and decrease when lying down. It can appear both on the day of surgery, and on the second or third day. Localization of pain can be any. In typical cases, pain occurs in the frontal region, bridge of the nose, above the eye sockets and in the temples, less often in other areas.

Back pain (in the lumbar spine) after anesthesia; goes away on its own after a few days. Usually, even analgesics are not required.

General anesthesia for caesarean section

For cesarean section, general anesthesia is performed if there are contraindications to regional anesthesia, and also in cases where the woman or the operating surgeon does not want the woman in labor to remain conscious during the operation: when there is a threat to life and immediate surgery is required, since general anesthesia works faster, if there is a suspicion of a dense attachment of the placenta (if the placenta cannot be separated manually, an emergency removal of the uterus is performed, and the removal of any organ is carried out only under general anesthesia), if local anesthesia fails.

The main risk of general anesthesia is associated with airway control. One of the most formidable complications of general anesthesia in obstetrics is the aspiration of gastric contents (as little as 30 ml of acidic gastric juice can lead to fatal pneumonitis).

If an operation is to be performed under general anesthesia, then the pain medication will be administered intravenously to the woman, and in a few seconds she will fall asleep. Once her muscles relax, the anesthesiologist will insert a tube into her trachea to secure her lungs and control her breathing. At the same time, the woman is in an unconscious state and is connected to an artificial respiration apparatus. During the operation, the patency of the respiratory tract and the state of the vital systems of the body are monitored: blood pressure and pulse are measured.

General anesthesia is a method of anesthesia, which today is used only in the most urgent cases.

A caesarean section is a surgical delivery in which the baby 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 high myopia. If myopia entails changes in the retina, then a caesarean section is the only way to deliver. 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 the countryside, so the choice of anesthesia was small, or rather, it did not exist 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. There was a strong weakness, dizziness, 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, as 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 baby, and I breastfed without any problems. The seam hurt for five days. Longer than the first time. But a week later, I happily forgot about it.

To summarize, 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. You can't see it under underwear at all. Giving birth through surgery is not scary. The main thing is to think about your baby. Health to you and your children!

Anesthesia for caesarean section is carried out in several ways, the choice of which depends on the decision of the doctors. The method of such delivery itself has been around for a long time. Its implementation is not complete without anesthesia. Consider all possible methods, list their features, contraindications and complications.

What is the best anesthesia for caesarean section?

Doctors do not give a definite answer. The choice of method is completely determined by the condition of the woman, time, and the presence of aggravating factors. When deciding which anesthesia to choose for a caesarean section, doctors lean towards regional anesthesia. With this manipulation, there is a violation of the process of impulse transmission along the nerve fibers a little higher than the place where the substance is injected. The patient remains conscious, which facilitates the process of manipulation, eliminates the need for withdrawal from anesthesia, and reduces complications. This is also a plus for the mother herself, who almost immediately establishes contact with the baby, hears his crying.

Types of anesthesia for caesarean section

Answering the question of women regarding what kind of anesthesia is done during caesarean section, doctors call the following possible types of it:

general, known as "anesthesia";
regional - spinal and

The first anesthesia for caesarean section is used in exceptional situations when there are contraindications to regional anesthesia. It is resorted to in the presence of specific obstetric cases, including the transverse location of the fetus, prolapse of the umbilical cord. In addition, pregnancy itself is often associated with such conditions when the process of tracheal intubation is difficult - the placement of a tube for anesthesia. With this manipulation, there is a possibility of stomach contents entering the bronchi, which causes respiratory failure, pneumonia.

How is a caesarean section done with epidural anesthesia?

This technique is widespread and effective. It consists in the introduction of a drug into the region of localization of the spinal cord. Manipulation begins half an hour before the scheduled time of delivery itself. Directly such an interval is necessary in order for the medicine to work. The injection zone is plentifully treated with an antiseptic solution, the injection site is marked.

With this type of anesthesia for caesarean section at the level of the lower back, the doctor pierces the skin with a special, sterile needle. Then, gradually deepening, they reach the space above the spine, in which the nerve roots are located. After that, a special tube is inserted into the needle - a catheter, which will serve as a pipeline for medicines. The needle is removed, leaving the tube, which is lengthened - attached to a greater length, brought to the shoulder girdle, where it is fixed. The agent is introduced gradually, if necessary, the dosage is increased. Provides easy access to the catheter.

The procedure for using the medication itself is performed in a standing position or in a position on its side. Manipulation is practically painless. Some women may experience minor discomfort, which is characterized as a feeling of pressure in the lumbar region. When the drug is administered directly, the patient does not feel anything. The procedure is highly efficient.

As a result, sensitivity is completely turned off, but the consciousness of the woman in labor is not turned off - she hears her newborn, his first cry. Talking about how long a cesarean section lasts with epidural anesthesia, doctors note that, depending on the dosage, the removal of sensitivity is fixed for 80-120 minutes. This time is enough for the operation.

Contraindications to epidural anesthesia for caesarean section

This method has positive qualities, but there are also contraindications. It is prohibited when:

inflammation of the area where it is necessary to make a puncture - pustules, papules;
blood clotting disorder;
individual intolerance to drugs;
diseases of the spine, osteochondrosis;
transverse or oblique location of the fetus.

Talking about the dangers of epidural anesthesia for caesarean section, doctors note that such manipulation requires experience and clarity. Damage to blood vessels, nerve endings causes irreversible consequences. Given these facts, the manipulation is carried out exclusively in large clinics, where there are qualified personnel, specialists. equipment.

Consequences of epidural anesthesia for caesarean section

Due to the fact that large doses of medication are required during surgery with this type of anesthesia, side effects are often noted. Among these it is worth noting:

pain in the back area;
headache;
tremor in the legs.

These phenomena disappear on their own, after 3-5 hours. They are associated with the effect on the body of the medicines used for the procedure. Complications after epidural anesthesia for caesarean section are rarely recorded. These include:

violation of the process of urination;
injury to the membranes of the spinal cord, a nearby nerve;
allergic reactions to the active ingredient of the drug.

How is spinal anesthesia performed for a caesarean section?

In this type of nerve block, the drug is injected directly into the fluid that surrounds the spinal cord. After the injection, the needle is removed. The woman is offered to sit down on a couch or operating table in such a way that her hands rest on her knees and her back is arched as much as possible. The injection site is treated with an antiseptic, an injection is made after which the subcutaneous tissue loses sensitivity and the procedure becomes less painful. A long and thin needle is used to make a puncture. It is injected directly into the cerebrospinal fluid. After removing the needle, a sterile bandage is applied.

Women who are about to have surgery are often interested in the question of how long a caesarean section lasts with spinal anesthesia. The duration of the process of such delivery is due to the professionalism of doctors, the absence of complications during the procedure. On average, this manipulation takes 2 hours from the moment of application of the remedy and injection into the lumbar region. This is how much the dosage of the anesthetic is calculated.

Contraindications for spinal anesthesia for caesarean section

Cesarean section with spinal anesthesia is not performed for:

lack of qualified medical personnel;
big blood loss;
severe dehydration of the body;
violations of the blood coagulation system;
infection, inflammation at the injection site;
allergies;
high intracranial pressure;
dysfunction of the central nervous system;
when using anticoagulants before surgery.

Consequences of spinal anesthesia for caesarean section

This type of desensitization comes with some consequences. The following complications often develop after spinal anesthesia for caesarean section:

a sharp drop in pressure;
headache;
disruption of the nervous system;
pain in the lumbar region;
damage to the spinal nerves;
violation of the integrity of blood vessels.

General anesthesia for caesarean section

Such anesthesia for caesarean section is its oldest variety. Rarely used in modern obstetrics. This fact is due to the lack of the ability to control the state of the woman in labor, as she plunges into a deep sleep, does not feel anything. in the absence of the necessary equipment and specialists. It is carried out by intravenous infusion of the drug. The duration of its action depends on the type of medication, its dosage and is 10-70 minutes.

Asking the doctor what kind of anesthesia is best for caesarean section, a pregnant woman often hears about the positive features of a regional one. At the same time, the doctors themselves indicate that not all maternity hospitals practice it. Large, modern, private clinics always use this technique. So it is possible to reduce the risks and consequences of general anesthesia, the effect of drugs on the fetus is excluded.

Local anesthesia for caesarean section

Talking about what anesthesia is used for caesarean section, it is worth noting local anesthesia. They resort to it when it is necessary to reduce sensitivity, relieve pain during a puncture and injection of a medication into the spinal region. In this case, a small dosage of the drug is used. An intradermal injection is made. After that, the woman practically does not feel the entrance of the needle.