Cesarean Section Anesthesia: General Explanation

This is a general explanation of the anesthesia used during a cesarean section.
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Types of Anesthesia Used in Cesarean Section

During a cesarean section, injections are usually administered in two places on the back.

Epidural Anesthesia

The brain and spinal cord are suspended in cerebrospinal fluid, which is enclosed by a tough membrane called the dura mater.
In epidural anesthesia, a very thin tube called a catheter is inserted outside the dura mater.
This is used for pain relief after the surgery.

Spinal Anesthesia

This is a technique in which a fine needle is inserted into the lower back to administer a local anesthetic into the cerebrospinal fluid surrounding the spinal cord.
This results in temporary numbness of the lower half of the body, eliminating pain sensation in the lower body.
The effects of the anesthesia typically last for approximately three to four hours, during which the surgical procedure will take place.

Before the Cesarean Section

Once a cesarean section is scheduled, please follow the provided instructions carefully and take care of your health.
Should you experience any health concerns, please do not hesitate to contact us.

You can eat dinner as usual the day before the cesarean section.
However, after that, you will not be able to eat until the surgery is completed.
Please avoid snacks and other foods as well.

Regarding fluids, drinking water may be allowed under specific conditions.
If you have not received any instructions, please confirm with your medical provider.

On the Day of Surgery

You will be guided to the operating room or delivery room and asked to lie down on a bed.

Electrocardiogram monitors, a blood pressure cuff, and an oxygen monitor will be attached.
An intravenous line will also be inserted.

You will then be instructed to lie on your side.
At this time, curling the back like a shrimp helps open the spaces between the vertebrae, making the procedures easier.

After the doctor confirms the position of the spine, the area will be disinfected.
Once the disinfectant dries, a sterile drape will be placed.
The doctor will then inform you before injecting a local anesthetic with a fine needle.

Once it is confirmed that the local anesthetic is effective, the epidural anesthesia will begin.

After that, spinal anesthesia is performed in a similar manner.

During Anesthesia

Both types of anesthesia involve inserting a needle between the spine, which is a very delicate technique.
Therefore, it is important to remain as still as possible.

If you feel anything unusual, such as a sharp, electric shock-like pain, please inform the doctor immediately.

Once the medication is injected, you may feel warmth in your legs or buttocks, which is one of the effects of the anesthesia.

After Anesthesia

Once the procedures are finished, you will be placed on your back, and the effectiveness of the anesthesia will be checked before the surgery begins.

After the baby is delivered, you may be allowed to sleep with sedatives if desired.

Risks and Complications of Cesarean Anesthesia

Although the mortality rate is extremely low, any drop in blood pressure will be treated with medications and IV fluids.
If excessive bleeding occurs, a blood transfusion may be required.

In the unlikely event of an unexpected medical emergency, all necessary life-saving measures will be taken.
In rare cases, you may be transferred to the intensive care unit (ICU) for further monitoring.

Rare complications include:

• Epidural hematoma: Uncontrolled bleeding inside the spine can compress the spinal cord.
• Cauda equina syndrome: Nerve damage affecting the lower spinal cord.

More common complications include:

• Headaches
• Severe pain
• Numbness
• Discomfort

If any of these occur, contact medical staff immediately.

Alternative Anesthesia Options

This is the general procedure, but the method of anesthesia may be changed depending on the situation.

There are certain conditions under which these types of anesthesia may not be possible.
If any of these conditions apply, you should inform the doctor.

Additionally, if the spaces between the vertebrae are extremely narrow, these procedures may not be successful.
If epidural anesthesia is not possible, postoperative pain relief will be substituted with another method such as a nerve block.

Furthermore, if spinal anesthesia is unsuccessful, or even if it is successful but the cesarean section cannot continue under spinal anesthesia due to certain circumstances—such as when the baby's condition worsens and the surgery needs to be expedited—general anesthesia may be used instead.

Conclusion

This concludes the explanation.
Thank you for your attention.