Anesthesia for C-Section

During a Caesarian Section, the surgeon uses one hand to lift the baby’s head through an incision in the lower abdomen while the surgical assistant presses on the upper abdomen.

In the event you are scheduled for a c-section, someone from the anesthesia care team will review your medical condition and discuss the anesthesia option that is best suited for you. Under most circumstances, undergoing a c-section via Spinal Anesthesia or Epidural Anesthesia (rather than General Anesthesia) is preferred since it involves less risk and has the advantage of allowing you to be awake during your baby’s birth. In some cases, general anesthesia may be the best option depending on your medical condition. Your anesthesiologist can discuss this topic further during the evaluation process.

What is the difference between a spinal and an epidural for C-section?

Spinal Anesthesia uses a very thin needle that is placed in your spine where the spinal fluid is located. This space is a few millimeters further in from the epidural space in your spine. Medication is injected directly into the spinal fluid and the needle is then immediately withdrawn. You will begin to get numb within seconds and will be fully numb within a few minutes.

Epidural Anesthesia uses a thicker needle that is placed in your spine and guided towards the epidural space. A thin tube (catheter) is passed inside the needle into the epidural space and the needle is then taken out. The catheter remains in your spine (epidural space) and is taped to your skin. Medication is then injected into the epidural catheter to numb the lower part of your body. Since medication is not directly injected into the spinal fluid, more of it is needed to achieve the same level of numbness as a spinal. Full numbness is achieved within 20 minutes.

What are the pros and cons of spinal versus epidural techniques?

Spinal Anesthesia

Pro:

  1. Probability of complete numbness may be slightly higher.
  2. Numbness can be more intense, so less pressure sensation can be felt during surgery.
  3. Quicker to get numb once medication is in.
  4. Less medication is used to achieve numbness for the surgery.

Con:

  1. Inability to give more medication via your spine once surgery proceeds.
  2. After surgery, pain medication is given via your IV rather than in the spine. Pain medicine given in the spine may work better.

Epidural Anesthesia

Pro:

  1. More medication can be added through the epidural catheter if needed during surgery.
  2. The epidural catheter can be used to give pain medication into the spine after your surgery.

Con:

  1. There is slightly higher chance that some areas may not be completely numb.
  2. More medication is needed to achieve the same amount of numbness compared to the spinal method.
  3. Catheter taped to your back may cause skin irritation in the days following your c-section.

Ultimately, the decision to utilize the spinal or epidural route for a caesarian requires discussion with your anesthesiologist after considering all the medical options unique to your case. Risks for this method of anesthesia are outlined in the Anesthesia for Childbirth FAQ section.

What are some of the possible side effects I may experience from epidural or spinal anesthesia?

The more common side effects include the following:

  1. Shortness of breath – Since your chest will be partially numb, you may feel short of breath even though you are still able to breathe fine. Your anesthesia team will monitor your breathing closely and provide assistance with your breathing if necessary.
  2. Nausea – This symptom can be successfully treated with medication during the c-section procedure.
  3. Shivering – The combination of regional anesthesia, intravenous fluids administered, and physiologic changes occurring during the birthing process contribute to this symptom. Oftentimes, this is successfully treated with medication.

What if I need to undergo a general anesthetic for my C-section?

Under certain circumstances, it may be decided that General Anesthesia is the best method for your c-section. This would involve putting you completely to sleep for the procedure. You will be moved to the OR bed and then prepped for surgery. Once the drapes are placed and the surgeon is ready to proceed, the anesthesiologist will inject medicine in your IV to put you to sleep. After you are asleep, a tube will be inserted into your mouth and down your airway to manage your breathing . During the surgery, your stomach will be suctioned. At the end of the surgery, all tubes will be removed from your mouth. You will awaken in the recovery room where a nurse will attend to your care.

What are some of the side effects associated with general anesthesia?

  1. Nausea – This symptom can be successfully treated with medication by your recovery room nurse.
  2. Pain – During you c-section, you will be administered narcotics through your IV so that you will wake up with minimal to no pain. Once you are awake, your recovery room nurse will closely follow your pain level and give you additional pain medication if needed.
  3. Sore throat This symptom may result from having had a tube placed in your airway while under general anesthesia. Normally, your throat will be better within three days.

For information on awareness/recall under anesthesia, please click here.