Anesthesia for Cesarean Delivery

2019 ◽  
Author(s):  
Emily E. Naoum ◽  
Rebecca D. Minehart
Keyword(s):  
Cesarean Delivery ◽  
Deep Understanding ◽  
Obstetric Anesthesia ◽  
Anesthetic Technique ◽  
Vaginal Birth After Cesarean ◽  
Anesthesia Providers ◽  
Gastric Contents ◽  
Potential Risks ◽  
Hypotensive Syndrome ◽  
Preparation Techniques

Cesarean delivery is a cornerstone of obstetric anesthesia and it is imperative for providers to have a deep understanding of the indications, preparation, techniques, and potential complications of both the procedure and the anesthesia. It is necessary to obtain a focused but thorough history and physical and to develop an appropriate individual by considering a multitude of factors including co-morbid maternal and fetal conditions, timing of delivery, technical needs of the surgeon, potential adverse events, and systems based decision making. Anesthesia providers need to determine the safest method to provide anesthesia for the mother with an aim to minimize risk to the fetus. Once the decision of which anesthetic technique will be utilized is made, the provider must have the knowledge of how to best execute the plan and remain vigilant by maintaining a back-up plan in the case of complications. Obstetric anesthesia for cesarean delivery carries a set of unique challenges and potential risks in addition to the standard risks associated with general and neuraxial anesthesia. This review contains 5 figures, 6 tables, and 86 references. Keywords: Maternal Physiology, Maternal-Fetal Considerations, Systemic Medications, Cesarean Delivery, Difficult Airway, Aspiration Prophylaxis, Supine Hypotensive Syndrome, Aspiration of Gastric Contents, Vaginal Birth After Cesarean Section (VBAC)

Nonobstetric Surgery during Pregnancy: An Overview for Anesthesia Providers

2018 ◽  
Author(s):  
Rebecca L Hamilton ◽  
Elizabeth Young Han ◽  
Dan M Drzymalski
Keyword(s):  
Obstetric Anesthesia ◽  
Anesthesia Provider ◽  
Anesthetic Technique ◽  
Clinical Practices ◽  
Scientific Methods ◽  
Randomized Controlled Studies ◽  
Anesthesia Providers ◽  
Improved Outcomes ◽  
The Us ◽  
Key Words Anesthesia

A pregnant patient’s surgery can be challenging for the anesthesia provider—the needs of the parturient and fetus must be addressed while balancing the physiologic and pharmacologic changes that occur during pregnancy. Improved outcomes have led to an increase in the frequency of surgeries in parturients, with approximately 50,000 procedures performed annually in the US. Due to a lack of randomized controlled studies, determining the optimal anesthetic technique for nonobstetric surgery during pregnancy is predicated on understanding the physiologic changes of pregnancy. The anesthesia provider must become familiar with specific changes and challenges in each parturient to formulate a safe anesthetic plan. Here, we review physiologic and pharmacologic conditions observed in common surgical cases that may occur during pregnancy. Our goal is to inform safe clinical practices determined by the latest scientific methods for nonobstetric surgery during pregnancy.    This review contains 5 figures, 3 tables and 45 references. Key Words: anesthesia, nonobstetric surgery, obstetric anesthesia, pregnancy, surgery, physiology, pharmacology, gynecology

Nonobstetric Surgery during Pregnancy: An Overview for Anesthesia Providers

2018 ◽  
Author(s):  
Rebecca L Hamilton ◽  
Elizabeth Young Han ◽  
Dan M Drzymalski
Keyword(s):  
Obstetric Anesthesia ◽  
Anesthesia Provider ◽  
Anesthetic Technique ◽  
Clinical Practices ◽  
Scientific Methods ◽  
Randomized Controlled Studies ◽  
Anesthesia Providers ◽  
Improved Outcomes ◽  
The Us ◽  
Key Words Anesthesia

A pregnant patient’s surgery can be challenging for the anesthesia provider—the needs of the parturient and fetus must be addressed while balancing the physiologic and pharmacologic changes that occur during pregnancy. Improved outcomes have led to an increase in the frequency of surgeries in parturients, with approximately 50,000 procedures performed annually in the US. Due to a lack of randomized controlled studies, determining the optimal anesthetic technique for nonobstetric surgery during pregnancy is predicated on understanding the physiologic changes of pregnancy. The anesthesia provider must become familiar with specific changes and challenges in each parturient to formulate a safe anesthetic plan. Here, we review physiologic and pharmacologic conditions observed in common surgical cases that may occur during pregnancy. Our goal is to inform safe clinical practices determined by the latest scientific methods for nonobstetric surgery during pregnancy.    This review contains 5 figures, 3 tables and 45 references. Key Words: anesthesia, nonobstetric surgery, obstetric anesthesia, pregnancy, surgery, physiology, pharmacology, gynecology

scholarly journals Publisher Correction: Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Cegolon ◽  
G. Mastrangelo ◽  
G. Maso ◽  
G. Dal Pozzo ◽  
L. Ronfani ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Vaginal Birth After Cesarean ◽  
North Eastern ◽  
Friuli Venezia Giulia

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

scholarly journals Assessment of Maternal Satisfaction and Associated Factors among Parturients Who Underwent Cesarean Delivery under Spinal Anesthesia at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse
Keyword(s):  
Logistic Regression ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Anesthetic Technique ◽  
Spinal Block ◽  
Maternal Satisfaction ◽  
Cross Sectional ◽  
Multivariable Logistic Regression

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.

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