Applied types of anesthesia in cesarean section are divided into two areas: general anesthesia, and regional anesthesia. Of the regional anesthesia in the world for in labor, epidural anesthesia, spinal anesthesia and a combination of spinal epidural anesthesia are used.
General anesthesia
Another 10 years ago, general anesthesia was the main type of anesthesia in cesarean section. Experts who mastered safer regional anesthesia were not enough. Currently, general anesthesia is used only in rare cases:
- In the presence of contraindications to epidural and spinal anesthesia (acute bleeding, coagulopathy, thrombocytopenia, etc.);
- In specific obstetric situations (prolapse of the umbilical cord, transverse position of the fetus, etc.);
- In emergency cases, when there is no time to prepare and conduct regional anesthesia.
With caesarean section, general anesthesia causes more complications and is more difficult to bear than the local one. When pregnancy changes patency of the respiratory tract, so there are problems with intubation of the trachea. The risk of ingestion of gastric contents in the respiratory tract is significantly increased, causing pneumonia and severe respiratory failure. Anesthetics, used in general anesthesia, strongly "beat" the body not only mother, but also a baby. The newborn can be disturbed by breathing, the nervous system is depressed. There is a retardation, drowsiness, excessive lethargy, which makes it difficult for doctors to make a conclusion about the condition of the newborn.
Regional anesthesia
Epidural and spinal anesthesia in cesarean section is considered the "gold standard" of anesthesia. These methods are similar to each other. They "cut off" the pain only in a certain part of the body. At the same time the mother is in the mind and can observe the birth of her child. Regional anesthesia is performed by puncturing and injecting an anesthetic into the lower back - into a special area near the spinal cord.
The difference is that the medicine with spinal anesthesia is injected with a needle into the liquid that is washing the spinal cord. That is, this is an ordinary injection. And with epidural anesthesia, the drug is injected through the inserted catheter, which remains in the body until the end of the operation. Through it, it is convenient to administer other drugs without re-puncturing.
With spinal anesthesia, anesthesia occurs in 10-15 minutes, and with epidural only after 20-30 minutes. With general anesthesia, the patient rarely feels pain. And with regional anesthesia, the situation is somewhat different. It is not so rare after regional anesthesia that the parturient continues to feel pain. Sometimes the reason is the individual characteristics of a person. Sometimes, when the fights begin, the nervous system is overexcited and is not completely blocked. But sometimes the reason for the inefficiencies of regional anesthesia is the anesthesiologist's mistake.
If pain during cesarean section remains after spinal anesthesia, doctors usually switch to general anesthesia. But since general anesthesia is not safe for the newborn, with the consent of the mother, the operation can continue with very strong pain. Such cases, unfortunately, are not unique. Therefore, pregnant women who are planning a "painless" caesarean section only in order not to experience birth travails, it is worthwhile to think carefully about the consequences.
If the pain is felt after epidural anesthesia, then the solution is quite simple. A new dose of anesthetic is introduced through the catheter. True, it will only work if the catheter is correctly inserted. In addition, an additional dose of pain medication can affect the newborn.
Contraindications: infection in the field of anesthesia, individual intolerance, blood coagulability disorders, low platelets, etc.
Consequences: after cesarean with epidural anesthesia, severe headaches arise that require rehabilitation. After "spinalka" - headaches are not very strong.
Advantages: compared with general anesthesia is quite safe for the mother and child.