Caesarean Section

This text outlines the types of Anaesthesia available for a Caesarean Section. Your Anaesthetist will assess you prior to your Caesarean and discuss your anaesthetic with you in more detail. You can also obtain more information from your Obstetrician, Midwife and Antenatal classes.

This text is intended to provide information only. Please discuss individual circumstances with your anaesthetist.

Who administers anaesthesia for Caesarean Sections?

Anaesthesia for Caesarean Sections in Adelaide are administered by Specialist Anaesthetists. They are Medical Practitioners who have had a minimum of 5 years further Specialist Training in Anaesthesia, Pain Management and Intensive Care following their medical degree.

Types of Anaesthesia for Caesarean Section

There are four types of Anaesthesia available for Caesarean section:

Epidural and Spinal Anaesthesia allow the mother to be awake during the delivery of the baby by Caesarean Section. Local Anaesthetic solutions are administered into the spinal fluid (Spinal Anaesthetic) or into the Epidural Space outside the covering (Dura) of the spinal canal (Epidural Anaesthetic). This causes loss of sensation up to the level of the breasts and loss of movement in the legs during the Caesarean Section.

Your partner can be present at the delivery with epidural or spinal anaesthesia. The baby is usually more alert at delivery after this form of anaesthesia. Currently most women and anaesthetists choose to have this form of Anaesthesia.

General Anaesthesia (GA) is also occassionally used for a Caesarean Section. With GA you have intravenous drugs to induce you to sleep and you are kept asleep with a combination of Anaesthetic gases and intra-venous drugs whilst the baby is delivered. There are some Medical or Obstetric conditions where General Anaesthesia is preferable but generally spinal or epidural anaesthesia is the preferred option because it is safer.

Pre-anaesthetic Consultation

Your Anaesthetist will assess you prior to Caesarean Section and discuss your Anaesthetic with you. This will generally occur on the day of your Caesarean Section. You may see your Anaesthetist prior to this if you have had previous Anaesthetic problems, Medical problems or if you have specific issues you would like to discuss. You can arrange this by asking your Obstetrician who your Anaesthetist will be or contacting Specialist Anaesthetic Services 8273 5666.

Side Effects of Anaesthesia for Caesarean Section General Anaesthesia

Common Side Effects

General Anaesthesia for Caesarean Section shares the common side effects of GA for many other operations. These include nausea, drowsiness, sore throat and dry mouth.

Rare Side Effects

As with other forms of surgery General Anaesthesia has a very small risk of severe allergic or unusual reactions. The risk of these is probably less than 1 in 20,000. Please discuss these with the anaesthetist.

Side Effects more common with GA for Caesarean Section

Regurgitation and Inhalation of Gastric Contents

Pregnant women are more prone to gastric reflux. This means women having Caesarean Section require techniques to minimise the risk of inhaling gastric contents. These include antacid medication given before the operation and protecting the airway with a tube in the trachea during the anaesthetic. The universal use of these preventive measures and increased use of epidurals have markedly reduced the incidence of this serious problem.

Difficult Airway

Pregnancy can cause difficulties in managing the airway in women. Your Anaesthetist will assess your airway prior to Anaesthesia. Some women will require epidural or spinal anaesthesia if difficulty in managing the airway is anticipated. In these situations Anaesthetists use their expert airway management skills to secure an airway.

Awareness of Surgery

In the past General Anaesthesia for Caesarean Section was quite “light” because there was a fear that “heavy” anaesthesia would harm the baby. We now know that babies can tolerate the effect of anaesthetic delivered to the mother at Caesarean Section, consequently higher doses of anaesthetic drugs and anaesthetic gases are administered to the mother with a very much lesser risk of “awareness” of surgery with little risk to the baby.

Side Effects of Spinal and Epidural Anaesthesia for Caesarean Section

Awareness of surgery

All women having epidural or Spinal Anaesthesia for Caesarean Section will feel some movement, tugging and pulling. For most women there will not be discomfort associated with these sensations. It is important to be aware that these sensations do not mean you will feel pain.

Discomfort or Pain during surgery

Some women will feel discomfort or pain and may need medication through their intravenous line to control this. About 1 in 200 women will require General Anaesthesia if their discomfort cannot be controlled. It is important to advise your Anaesthetist if there is any discomfort and they will assess you and the stage of the operation and decide how best to manage this.

Spinal Headache

As with epidurals in childbirth both epidural and spinal anaesthesia for Caesarean section have a risk of causing a spinal headache. This is a headache due to leakage of spinal fluid which may occur if the epidural needle causes an accidental “dural tap” or if there is a spinal fluid leak after a Spinal Anaesthetic. The needle used for Spinal Anaesthesia is very fine and has a special tip designed to minimise spinal headache. The chance of a severe spinal headache is similar with both Spinal and Epidural Anaesthesia and is approximately 1 in 200.

Pain Relief following Anaesthesia

Techniques available for pain relief depend on the form of Anaesthesia administered. Techniques include a combination of the methods outlined below

Side effects of the pain relief may include: nausea, vomiting, drowsiness or itchiness. These side effects will be treated if and when they occur.