In detail

Caesarean section

Caesarean section


- On March 29, I am scheduled for caesarean section: what anesthesia allows the baby to breastfeed the very next day?


The modalities used during a cesarean operation are the following:
• AG IOT - most commonly used;
• spinal anesthesia;
• local anesthesia;
• Peridural anesthesia.
However, the harmfulness of the caesarean section on the newborn is also due to the anesthesia used, due to its negative influence on the respiratory center of the fetus.
General anesthesia for cesarean section - ensures:
• hypnosis;
• muscle relaxation;
• analgesia;
• hemodynamic stability.
General anesthesia, due to the narcotic medication used, requires a very rapid extraction of the fetus after hysterotomy, before the anesthetic substance reaches the fetus and the respiratory tract depression occurs.

Both the comparative values ​​of the Apgar score at one minute and five minutes, as well as the comparison between the number of girls with neurological abnormalities, show us the inferiority of the general anesthesia compared to the peridural analgesia for example.
The opioid analgesic is injected after fetal extraction to avoid respiratory depression.
The biochemical state of the mother and especially of the baby born through the cesarean section is due not only to the type of anesthesia, but also to its duration, especially to the general one, which is an important factor influencing the newborn's condition.
Rahianesthesia for Caesarean section - has two major drawbacks:
• marked hypotension (especially if it is associated with cavity syndrome);
• postoperative headache - occurs about 36-48 hours after the operation.
For these reasons, the percentage of spinal anesthesia for Caesarean section remains relatively low compared to general anesthesia for example.
Uncontrolled and uncorrected spinal anesthesia during the intervention results in fetal anoxia through maternal hypotension, retraction of the uterus on the fetus and decreased blood supply to the placenta. If spinal anesthesia is controlled and corrected it is not harmful to the fetus.

Local anesthesia

There are doctors who argue that local anesthesia is superior to other types of anesthesia because it does not negatively influence either the mother or the fetus and offers the doctor optimal conditions for work, but the operator's and mother's comfort when performing the surgery is inferior to the other anesthesia modalities. .
Peridural anesthesia - most commonly used for patients who started with a natural birth; in case it is decided to terminate the birth by caesarean section, continue with epidural anesthesia. There are also patients scheduled for caesarean section who require epidural anesthesia as an anesthetic modality.
As a technique, the catheter is mounted and the anesthetic injected 30 minutes before the start of caesarean section. The comfort of the patient can be increased with an additional intravenous anesthesia (hypnotic of the type dormicum or diazepam), being kept the spontaneous ventilation of the patient.
The epidural kit is found in hospitals, but in this regard there are differences from hospital to hospital. I do not advise you to buy it before talking with your doctor because the anesthesiologist may prefer only a certain type of kit, so it is advisable to inform yourself before buying it.
Epidural anesthesia has gained ground in competition with the other modalities of anesthesia during the caesarean section for several reasons:
• the mother is aware of what is happening and can act in support of an entry into life as pleasant as possible for the newborn;
• the anesthetic risk is very low both in terms of the mother and the newborn;
• doses of anesthetic can be controlled more effectively and the effect is more specific.
The anesthesia that I consider optimal during the caesarean section is epidural anesthesia, the same one that I recommend for vaginal birth, but this depends on your situation, pregnancy and implication of the fetus at birth; the final decision being taken by the anesthetist together with the obstetrician doctor who monitored your good pregnancy development.

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