Regional anaesthesia for caesarean section (and what to do when it fails)

Abstract: Regional anaesthesia is the technique of choice for caesarean sections, with single-shot spinal most commonly used. Preoperative assessment must be undertaken in all women, and informed consent is mandatory. Antacid premedication should be given to both elective and emergency cases. Maternal obesity is a risk factor for failed regional anaesthesia. Light-touch is the most reliable way of assessing the block, and the level should be documented prior to surgery. Inadequate block is a frequent cause of litigation, and all women should be offered general anaesthesia. Good communication with the parturient and the obstetricians and detailed documentation are essential if this occurs. Management options include repeating or supplementing the block, nitrous oxide, opiates, ketamine or resorting to general anaesthesia. All caesarean sections require follow-up postoperatively.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: Obstetric anesthesia Source Type: research