Methods of pain relief during surgical childbirth. Anesthesia for caesarean section

Caesarean section is intended to remove the baby from the abdominal cavity if for some reason a woman cannot give birth naturally. The date of cesarean section is usually set in advance; preparations are made for this operation, including choosing anesthesia.

If anesthesia is caesarean section has already been chosen by the mother in labor or by the doctor, then you should know how it will be carried out, what 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 - type local anesthesia, which is performed by injecting an anesthetic into the spinal space, causing loss of sensation in the lower part of the 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 woman in labor goes numb bottom half bodies. At the same time, the woman herself remains conscious and can help doctors monitor her condition.

How is spinal anesthesia administered for caesarean section?

The most popular starting position for administering medications is the fetal position, when the woman lies on her side and brings her knees bent 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 like a wheel. Anesthesiologists prefer the first option, because when the sensitivity of the lower body is lost under the influence of the medicine, it will be easier for a woman in labor to roll over onto her back while lying on her side.

Then the first injection of anesthesia occurs. There will be two injections, because the second one is incredibly painful, and the woman in labor does not need to experience additional stress. The first injection affects a small area. Thanks to the first injection, the skin and tissue underneath become insensitive to pain, and the second needle can pass freely without causing discomfort.

The next step is a kind of puncture. Only cerebrospinal fluid They are not taken away for analysis, as with a regular puncture, but a second medication, an anesthetic, is injected there. 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. Lie on your side and rest your head on your outstretched arm. After a short time, the hand will go numb and feel like it’s not yours—about the same effect that will affect your body below your back during surgery.

Video: How to do spinal anesthesia

Who gets spinal anesthesia for caesarean section?

In addition to the patient’s personal choice, there are a number of indications that are likely to lead obstetricians to the decision to use spinal anesthesia for cesarean sections. These include:

a situation that poses a threat to the life of the fetus or mother, requiring immediate intervention. If general anesthesia is possible, most likely they will 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 with a caesarean section;
syndrome of late toxicosis of pregnancy (preeclampsia);
heart disease;
diabetes;
chronically high blood pressure;
kidney dysfunction.

Who should not have spinal anesthesia for caesarean section?

Spinal anesthesia contains a number of contraindications, the presence of at least one of which can lead to consequences that can even be fatal:

allergy to the anesthetic used (tests must be done before surgery);
strong pressure inside the skull;
fetal hypoxia
central disease nervous system;
acute infections (any, even herpes);
severe blood loss;
taking blood clotting medications before surgery;
lack 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 refusal by the patient cannot be violated.

Benefits of spinal anesthesia

Spinal anesthesia for caesarean section has a number of positive aspects. This type of pain relief does not affect the child’s body in any way. The drugs simply do not reach the baby, so they have no effect 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 provides pain relief within minutes and is therefore widely used during emergency labour.
With 100% probability it relieves pain in the entire lower part of the body. The effect of the anesthetic after injection lasts 1-4 hours (depending on the chosen drug)
The abdominal cavity can be prepared for surgery within 2 minutes after the administration of the anesthetic.
Spinal anesthesia for caesarean section has more light equipment injection versus epidural or general anesthesia.
The injection uses a thinner needle to administer the anesthetic compared to an epidural.
In rare cases, the effect on a child 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 cause toxic effects on the central nervous system or 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

Every type of pain relief has this point, because when working with medications there is always a risk of complications.

The drug is administered once. It is not advisable to add a dose. However, no doctor will be able to pre-determine how long the operation will last. And if something doesn’t go according to plan, the anesthetic will expire, but the operation will not. This does not mean that the caesarean section will be completed alive. The woman will simply be put under general anesthesia, however this procedure is also associated with risks, and in this case the woman in labor will not hear the baby’s first cry.
Neurological complications. Among the most frequent complications spinal anesthesia after cesarean section is called headaches that may not go away for weeks or even months.
Demotion blood pressure in a woman in labor. Although there is no direct effect of the drugs on the baby’s body, the consequences of the mother’s pain relief can still affect him. In particular, this is due to blood pressure, which drops after the anesthetic is administered. 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 medications. These are the drugs that can cause high blood pressure The child has. In turn, this affects his nervous system.

Epidural anesthesia for caesarean section

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

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

How to give epidural anesthesia for caesarean section

The first injection is performed in exactly the same way as in the case of spinal anesthesia - in order to numb the tissue in the area of the main injection. Right place wipe with alcohol-soaked cotton wool and perform an almost painless injection. The injected drug begins to act instantly, and you can feel how a small area of the body goes numb.

A second needle is inserted into the space between the spine and 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, so it blocks everything: the woman will not feel touch either.

A catheter is then 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 removed, but the catheter remains. Now, through it, new doses of anesthetic can be supplied to the woman’s body. The medications begin to take effect approximately 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 making a final choice. Epidural anesthesia for caesarean section is definitely prohibited for those who:

there are spinal injuries - as in this moment, and previously transferred;
chronically low blood pressure;
risk or initial development 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 also has a number of advantages:

The woman is also conscious, can control her breathing and will hear the first cry of her baby.
Blood pressure drops little by little, allowing doctors to better control it.
If the operation is delayed for any reason, anesthesia can be prolonged without transferring the woman in labor to general anesthesia.

Disadvantages of epidural anesthesia

For a doctor it is quite complicated. And if he performs any element of the manipulation incorrectly, this may affect the course of the operation.
It is easier for a needle to penetrate the wrong wall and introduce drugs into the blood. If the epidural anesthetic gets into circulatory system, it is impossible to notice and localize this problem immediately. That is, for some time the medicine will go to the wrong place. This is fraught with poisoning and even death.
Another consequence of breaking the “wrong wall” is a spinal block. It can stop the heart.
While epidural anesthesia for caesarean section begins to take effect, the mother's falling and rising pressure can cause hypoxia in the child.
This type of anesthesia may not work at all or may only numb one part of the body. It is impossible to predict such a result.
Possible penetration of cerebrospinal fluid where it should not be. Anesthesia after a cesarean section will end, but pain in the head and back will remain, and for a long time.

Until the anesthesia wears off, make sure that you are placed on the bed correctly - your legs should not bend or lie unnaturally.

The effect of epidural anesthesia on a child

When drugs enter a woman’s body, they also have an effect on the child’s body. Depending on the type of painkiller, the effects may vary. As a rule, they are as follows:

the baby's heartbeat becomes irregular or too slow;
the occurrence of fetal hypoxia;
improper breathing after birth, sometimes this requires artificial ventilation.

General anesthesia for caesarean section

For some women giving birth, general anesthesia for caesarean section is best view anesthesia. It should be noted that general anesthesia is the most complex type of anesthesia.

How is general anesthesia administered for a caesarean section?

The woman is given an injection of anesthetic, then an oxygen tube is placed to provide ventilation while the woman is under anesthesia. The drug begins to act literally 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 gets general anesthesia for caesarean section?

As a rule, general anesthesia for caesarean section is indicated for those women in labor who cannot undergo other types of anesthesia, but need to undergo a caesarean section. But there are other options:

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

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

Benefits of general anesthesia

Effective 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 there is a risk of insufficient effect or preliminary termination. Besides, without even feeling own muscles, a woman in labor can strain them, since the brain is conscious during spinal and epidural anesthesia.
Many women are afraid of the sight of blood. Of course, with other types of anesthesia, the patient does not see the caesarean section process: doctors always place a screen at chest level to block 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 worries about “what if something goes wrong,” some women prefer complete loss of consciousness.

Disadvantages of general anesthesia

Nausea, headache and a 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 the woman in labor is given a tracheal tube, and it can irritate the respiratory tract.
Even in a semi-conscious state, a woman retains vomiting reflex. When a tracheal tube is inserted, the stomach may vomit contents. Life-threatening aspiration will occur.

There is no need to listen to those who claim that the mother-child bond will somehow be broken if the mother does not hear his first cry. You carried the baby for nine months. A few hours of him 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 scary or cowardly about choosing 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. Nowadays, new types of anesthesia are being developed, but they all still have an effect on the baby. In particular:

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

Summing up

Each type of anesthesia has its own advantages and disadvantages. Which anesthesia to choose for a caesarean section is decided subjectively by the pregnant woman; the doctor objectively helps her, depending on individual characteristics and possible deviations while carrying a child. Factors influencing successful anesthesia depend on the right choice painkiller, the type of anesthesia itself, as well as the professionalism of doctors and the availability of appropriate conditions for carrying out this event.

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

The expectant mother, who medical indications If she is facing a method of childbirth such as a caesarean section, willy-nilly she is wondering what kind of anesthesia is best for her to use for this operation.

Among the methods of pain relief that are used during a “caesarean section,” two categories can be distinguished: anesthesia, in which the woman in labor remains conscious (anesthesia), and general anesthesia, a method in which the woman’s consciousness is completely turned off. That is, there is no such thing as general anesthesia for a “caesarean section”.

Today we will talk specifically about general anesthesia; this is a fairly broad topic. If you want to learn more about anesthesia, you can do this on our website, in an article dedicated to this topic.

So, what kind of anesthesia is given for a caesarean section? Let's start with the fact that general anesthesia for caesarean section is not a common practice in modern maternity hospitals. Doctors, as a rule, try to resort to anesthesia in order to leave expectant mother conscious. But in some cases this measure is necessary. Let's figure out which ones exactly.

First of all, general anesthesia is used for “caesarean section” in the event that the operation is performed on an emergency basis and there is no time for difficult process There is simply no way to administer local anesthesia.
Such a measure may be necessary if anesthesia is contraindicated for medical reasons for a woman in labor, for example, if there is a focus of inflammation at the site of the procedure.
General anesthesia is used in case of oblique or transverse presentation of the fetus
In case of morbid obesity in a woman in labor, umbilical cord prolapse or placenta accreta
If the woman has previously had spinal surgery
Well, in the event that the expectant mother categorically refuses local anesthesia

Types of anesthesia for caesarean section

Under what anesthesia is a caesarean section performed? There are two ways: intravenous and endotracheal. Let's talk about the pros and cons of each.

(A video of how general anesthesia is performed during a “caesarean section” can be found on our website).

Intravenous general anesthesia

This method is done using intravenous injection, in which a specially calculated dose of an anesthetic drug is injected into the body, based on the patient’s weight. As a result, the central nervous system is inhibited, consciousness turns off and complete muscle relaxation occurs.

pros

Complete, 100% pain relief
Absolute muscle relaxation, which makes the doctor’s work easier
Speed of implementation, this method will save time when it is really necessary
Does not affect both blood pressure and heart activity
An anesthesiologist can control both the depth and duration of anesthesia throughout the operation.
This method is much simpler in technique than, for example, spinal or.

Minuses

When using this method, the risk of complications for both mother and baby is too high. Intravenous anesthesia is fraught with breathing problems for the child, as well as disturbances in the functioning of the central nervous system
The woman in labor may experience hypoxia, as well as involuntary release of stomach contents into the trachea
If during the operation it is necessary artificial ventilation lungs, the patient's blood pressure may rise. It is possible that a violation heart rate.

Doctors strongly discourage the use of the intravenous method, and if the choice arises as to which anesthesia is safer to choose for a “caesarean section,” then it is better to choose the next method, which is somewhat safer, although it also has its own nuances.

Endotracheal general anesthesia

How is general anesthesia administered for a caesarean section? Here, a special tube is used to introduce an anesthetic into the body, which is inserted into the trachea.

Experts, if the use of general anesthesia cannot be avoided, focus on this method, since it has a number of significant advantages over the previous one.

pros

Inputable medicinal product penetrates the placenta much more slowly than with intravenous administration. Accordingly, the risks for the baby, which we discussed in the previous paragraph, are significantly reduced.
For the expectant mother, the possibility of both heart rhythm disturbances and cardiac function is significantly reduced. vascular system. After all, the device used to administer this type of anesthesia itself saturates the lungs with oxygen and removes carbon dioxide from them
The drug used for anesthesia enters the body in a much more precise amount, and changing its dosage is much easier
The anesthesiologist can fully control the oxygen saturation of the lungs, as well as the volume of their ventilation
With this method, the contents of the stomach cannot in any way enter the lungs

But with all the obvious advantages of endotracheal anesthesia, it, unfortunately, also has its disadvantages.

Minuses

Nausea
Headaches and muscle pain
Severe dizziness to the point of fainting
Muscle contractions, trembling
Weakening of consciousness
Injury to the mouth and throat may occur due to the insertion of the tube.
There may be a focus of infection in the lungs
Allergic and anaphylactic shock
Brain damage and damage nerve processes both in the mother and in the fetus

Caesarean section (CS) is surgery, which is carried out if natural childbirth is impossible for some reason. In this case, the doctor cuts the skin on the abdomen, separates the muscles and removes the newborn through the incision in the uterus. Local anesthesia or general anesthesia for caesarean section is used to disable pain sensitivity in the pelvic area, as well as to achieve maximum muscle relaxation in this area.

Caesarean section is performed in cases where natural childbirth is not possible

Several types of anesthesia meet these requirements: general intravenous and inhalation anesthesia, as well as regional, epidural and spinal anesthesia. Intravenous administration of the drug for anesthesia does not allow sufficient accuracy to control its content in the blood, which can lead to negative consequences for the child, therefore intravenous anesthesia They do not do it during a CS.

A CS is a full-fledged operation, which is accompanied by a violation of the integrity of the skin, muscles and other tissues, therefore, unlike childbirth, pain relief is required during it.

The doctor decides which type of anesthesia to choose after full examination the patient, taking into account her wishes and general state, the likely consequences for her and the child, as well as possible technical difficulties during the operation.

Planned and emergency caesarean section, what is the difference?

A CS is performed as planned or for emergency indications. In the first case, the decision on the need for surgical delivery is made long before the expected date of surgery and is agreed with the patient. They usually try to do a planned CS with minimal tissue trauma, since in this case there is no need for a detailed examination of the organs of the lower floor of the abdominal cavity and pelvis, and the time factor does not play such a significant role as in emergency surgery. In this case, the woman knows in advance about the upcoming operation and prepares for it psychologically. She perceives CS as an option natural birth appointed for a specific period.

A CS can be planned or emergency depending on the health status of the woman in labor.

An emergency caesarean section is performed if natural delivery is impossible, and further continuation of pregnancy threatens the life and health of the mother or fetus. In this case, the time allotted for the surgeon to remove the baby from the uterine cavity can be calculated in a matter of minutes, so less attention is paid to the size of the surgical trauma. The incision is made according to midline abdomen, because it is this access that provides an optimal overview of the pelvic organs and abdominal cavity, and allows us to identify and eliminate all disorders. In this case, the operation for the woman is stressful situation, for which she is not ready either mentally or physically, and it is difficult to predict how long such an intervention will last.

A CS can be performed routinely and for emergency indications. In the first case, regional anesthesia is more often chosen, in which the woman remains conscious; in the second, general anesthesia is performed.

Criteria for choosing a method of pain relief for caesarean section

If a CS is performed as planned, the method of pain relief is selected taking into account the wishes of the patient, but not to the detriment of existing indications and contraindications.

In both versions of CS, the anesthesiologist makes a decision on the method of pain relief, taking into account a number of factors.

In an emergency situation, it is easier for the anesthesiologist to decide which type of anesthesia is best to choose. In both cases, it is necessary to take into account:

Estimated duration of the operation: spinal anesthesia provides deeper pain relief than epidural, but more short-term. Both types of regional anesthesia are accompanied by a decrease in blood pressure, which can lead to fetal hypoxia if this condition is prolonged. For planned interventions with a low risk of complications, local anesthesia is usually chosen, for more extensive operations- general anesthesia.
Availability concomitant diseases and the general condition of the woman: the presence of osteochondrosis lumbar region spine or decreased blood clotting precludes epidural and spinal anesthesia, and general anesthesia is contraindicated if there is a history and family history of malignant hyperthermia.
Indications for surgery: if natural delivery is undesirable due to anatomical features (narrow pelvis) and is carried out routinely during the normal course of pregnancy, you can choose local regional anesthesia. In this case, the woman will have the opportunity to hear the first cry and see the baby in the delivery room. In emergency situations, it is better to give preference general anesthesia inhalational anesthetics latest generation. It provides maximum control over the mother’s vital functions, and will also save her from psychological trauma during an unplanned operation.

The effect of local anesthesia and general anesthesia on a child

Any type of pain relief can, under unfavorable circumstances, affect the condition of the newborn. Expressiveness possible consequences depends on what drug was used, how much of it was administered and in what way.

Any type of anesthesia can affect the baby

Since it is impossible to perform a CS operation without anesthesia, it is better to choose an anesthetic aid with minimal risks negative consequences in a specific clinical situation.

Spinal anesthesia involves the injection of a local anesthetic drug into the space between the spinal cord and the arachnoid membrane, that is, directly into the cerebrospinal fluid. In this case, the drug is retained by the blood-brain barrier and does not enter the mother’s blood, therefore, by itself, it cannot cause any consequences on the part of the child. When performing this type of anesthesia, the sympathetic innervation in the anesthesia zone is switched off, which leads to vasodilation and a decrease in blood pressure, primarily in the pelvic area. Prolonged hypotension can cause fetal hypoxia if the operation lasts a long time.
Epidural anesthesia differs from spinal anesthesia in that local anesthetic is not injected into the cerebrospinal fluid, but into the space between the dura mater and the wall of the spinal canal. It is there that the nerve roots are located, providing sensitivity to the skin, muscles and internal organs. A decrease in blood pressure in this case can also be a consequence of anesthesia, so the risk of fetal hypoxia, although small, is present. In addition, the drug from the epidural space very quickly enters the mother's blood and can cause undesirable consequences in the child.
General inhalation anesthesia is a complete loss of consciousness as a result of inhalation of a gas-air mixture consisting of narcotic gas and oxygen. This type of anesthesia provides the maximum level of control of blood pressure and other vital signs. important functions. However, in this case, the anesthetic drug enters the mother's blood and can affect the child. In case of use inhalational anesthetics of the latest generation (sevoflurane), the consequences for both the mother and the child are minimal, are quickly eliminated and do not in any way affect the development of the child in the future.

With any method of anesthesia, it is possible side effects on the part of the child, but individual selection of the method of administration, type and dose of anesthetic, as well as competent management of the anesthesia protocol minimizes the risk of complications in the child both during planned and emergency CS.

Labor is a complex process for which the body prepares in advance. However, some features of the course of pregnancy or the condition of the expectant mother are a contraindication for natural childbirth, so the child is born as a result of cesarean section. Despite the long history and prevalence of the operation, many women are worried and afraid of pain relief. What types of anesthesia exist and which ones are better and safer for mother and child?

Types of pain relief for caesarean section and their essence

A caesarean section is an operation to remove a fetus from the uterus by cutting tissue in the lower abdomen and uterus. It is carried out according to strict indications; the mere desire of the expectant mother, who fears a painful birth, is not enough.

Caesarean section is performed under general or local anesthesia and lasts approximately 30–40 minutes. In the process, the doctor makes an incision in the lower abdomen and uterus and removes the fetus. Special drugs are injected into the uterus to improve contraction, and the incision is stitched. All manipulations are performed under anesthesia to reduce pain.

During a planned caesarean section, the anesthetic is selected in advance, taking into account the preferences of the pregnant woman, her state of health and the course of pregnancy. If urgent pain relief is needed, general anesthesia is used.

Epidural anesthesia

Epidural anesthesia is widely used for pain relief. It has its advantages and disadvantages, which are taken into account by medical personnel, so in certain situations its use is unacceptable.

Epidural anesthesia for caesarean section leads to loss of sensation in a limited area of the body and is used mainly for interventions performed with preparation. Long time waiting for the nerve ending signals to “turn off” (about 20–30 minutes) does not allow its use in case of a sudden complication of normal labor activity when lost minutes can play a fatal role.

An anesthetic agent is injected into the lumbar region into the epidural space of the spine. Anesthesia creates an effect in which it is not possible to feel the lower part of the body, but the woman remains conscious.

The complexity of the procedure lies in the need for precise delivery of the anesthetic to the nerve roots. A special device that remains at the injection site after the injection allows you to add pain relief if necessary.

This type of anesthesia is used for:

dysfunction of the heart and kidneys;
gestosis;
lack of insulin.

Contraindications:

poor blood clotting;
hypotension;
the presence of infectious pathologies;
hypersensitivity to anesthetic;
suture on the uterus;
abnormal position of the fetus;
various pathologies of the structure of the spine (including as a result of injury).

Spinal pain relief

Spinal anesthesia – more modern method preparation for caesarean section. It can replace epidural pain relief with fewer contraindications. However, this type of anesthesia also has its disadvantages.

Spinal anesthesia can be used for a variety of surgeries, whether emergency or planned. The effect of the anesthetic begins approximately 10 minutes after administration. The doctor injects the drug through a long, thin needle into the spinal space between the 2nd and 3rd or 3rd and 4th vertebrae. Due to precise administration, the required dosage is reduced, which reduces the possibility of a dangerous effect of the drug on the expectant mother and child.

Spinal anesthesia is used in the same cases when the use of epidural anesthesia is acceptable. Contraindications include:

abnormal structure of the spinal column;
blood clotting disorder;
infectious and inflammatory processes;
increased intracranial pressure;
pathologies of the heart and nerves;
high probability of large blood loss;
oxygen starvation of the fetus, the presence of severe developmental defects;
intrauterine fetal death.

General anesthesia

Anesthesia is the oldest method of getting rid of sensitivity during operations. It is used for various surgical interventions for patients of any age. General anesthesia is mainly used for emergency operations because it has serious shortcomings.

The essence of the procedure is the intravenous administration of the drug or the woman inhaling a gaseous anesthetic through a special mask. The effect occurs 2-3 minutes after administration and lasts from 10 to 70 minutes, depending on the chosen dosage and type of anesthesia. In this case, the woman’s consciousness completely turns off, she is in a sleepy state and does not feel pain.

General anesthesia for caesarean section is used with caution for women in labor who have diseases of the heart muscle and blood vessels. Anesthesia is used for:

lack of time to wait for other drugs to take effect;
inability to use other means;
abnormal position of the fetus;
placenta accreta or early abruption;
obesity of a woman;
pathologies of the spine structure;
fetal hypoxia.

Advantages of each method

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Advantages of epidural anesthesia:

security normal functioning blood vessels and heart during surgery;
complete loss of sensitivity (anesthesia for caesarean section remains effective during and after the operation, in addition, it is possible to introduce a new dose of the drug as the procedure time increases);
fast recovery period(one day after a cesarean section, a woman can walk independently and care for the baby);
no impact on the fetal body systems;
lowering blood pressure, which helps reduce blood loss.

Benefits of spinal anesthesia:

safety for mother and fetus (does not penetrate the placenta);
restoration of strength occurs faster;
complete pain relief after one injection;
complete muscle relaxation;
using a thin needle to insert medicine(this reduces the risk of spinal injury and incorrect administration of the drug).

Advantages of general anesthesia:

speed of action;
security normal operation heart muscle during cesarean section;
easy administration of the drug;
complete relaxation of the woman’s muscles (this makes the doctor’s work easier);
the possibility of prolonging and intensifying anesthesia.

Disadvantages of epidural, spinal anesthesia and general anesthesia

Disadvantages of epidural anesthesia:

The complexity of the anesthetic administration procedure. If the anesthesiologist does not have sufficient experience and knowledge, his mistake can lead to the drug getting into the blood. This threatens the appearance of seizures, sharp decline pressure and serious damage woman's central nervous system.
In some cases, the effect of the anesthetic does not reduce sensitivity. During a caesarean section, a woman may experience pain. Before the operation, special screening tests should be carried out, and if necessary, increase the dosage.
If the drug gets into arachnoid membrane spinal cord a sudden stop in breathing may occur.
Long waiting time for anesthesia to take effect. This method not used for emergency operations.
If the drug enters the placenta, this leads to impaired breathing and functioning of the fetal heart muscle.

The main disadvantages of spinal anesthesia:

migraine and tingling in the back;
rapid administration of the drug provokes the development of hypertension;
inability to prolong the effect of anesthesia;
short-term effect (about two hours);
If instruments are processed poorly, there is a risk of developing meningitis and other pathologies.

Disadvantages of general anesthesia:

Weak oxygen flow to respiratory system moms. During anesthesia, lung volume decreases and the need for oxygen increases.
If personnel are inattentive, internal contents may be released digestive system into the respiratory organs.
Severe hypertension during fetal extraction during cesarean section.
Severe depression of the fetal nervous system, as the drug reaches the child through the placenta.

What determines the choice of type of anesthesia?

The doctor determines what anesthesia will be used. If during natural labor it acquires pathological character, and a caesarean section is required, the woman in labor needs general anesthesia. The effect occurs very quickly, which allows doctors to save the life of the mother and baby.

At planned operations Doctors have the opportunity to choose the type of anesthesia. In this case, the woman’s opinion is taken into account, therefore, if any questions or doubts arise, they must be resolved by the doctor before the operation. The choice depends on the individual characteristics of the mother's body, the course of pregnancy, the presence of diseases, the intrauterine position and the condition of the fetus.

Possible complications, effects on the mother’s body and consequences for the child

Any intervention in the natural birth process affects the body of the woman and child. To reduce the risk of negative consequences, you need to carefully choose the doctor and clinic for performing a cesarean section. From professionalism medical personnel The health and life of the baby and mother depends.

Epidural anesthesia for cesarean section causes headaches and discomfort in the back during the recovery period. Painful sensations can last from several days to 2–3 months. If the anesthetic gets into the bloodstream of the fetus, the child’s heart muscle and respiratory system may be disrupted. As a result, there are various complications after the baby is born.

After spinal anesthesia, a woman suffers from headaches. Appears general weakness, pressure decreases. In addition, during the recovery period, it is difficult for a woman to empty her bowels and bladder.

General anesthesia has the greatest impact on the body of mother and child. The woman experiences dizziness and confusion. She is often lost in time and space, especially in the first few days after surgery. Consequences general anesthesia also concern the child’s nervous system. This threatens to disrupt its growth and development.