The following text outlines the types of Anaesthesia available for Caesarean Section. Your Anaesthetist will see you and discuss your general health, progress of your pregnancy and 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.
In Australia, anaesthesia is administered and monitored by a fully qualified specialist anaesthetist. The anaesthetist is a medical practitioner who has undertaken a minimum five years of specialty training in anaesthesia, pain management and intensive care following their medical degree.
Your Anaesthetist will meet you prior to Caesarean Section and discuss your Anaesthetic with you. The Anaesthetist will ask you about your general medical history and about any medications and allergies. The Anaesthetist will also ask about your obstetric history and the progress of this pregnancy.
This consultation 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 by contacting us.
Types of Anaesthesia for Caesarean Section
There are four types of Anaesthesia available for Caesarean section:
- Spinal Anaesthesia
- Epidural Anaesthesia
- Combined Spinal/Epidural Anaesthesia
- General Anaesthesia
In Australia, regional anaesthesia – spinal, epidural and combined spinal/epidural anaesthesia – is commonly used for anaesthesia for caesarean delivery. This form of anaesthesia allows the mother to be awake during the delivery of the baby by Caesarean Section. The partner can also be present during the birth. The baby is usually more alert after this form of anaesthesia. The choice of anaesthesia follows a discussion between the mother and the anaesthetist.
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 a temporary loss of sensation up to the level of the breasts and loss of movement in the legs during the Caesarean Section.
General anaesthesia (GA) may used for 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. There are some Medical or Obstetric conditions where General Anaesthesia is preferable.
Side Effects of General Anaesthesia for Caesarean Section:
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.
Other 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 minimize 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.
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.
Anaesthetists now often use a monitor of brain wave activity as an indicator of depth of general anaesthesia and potential awareness. This is the Bispectral Index, or BIS, monitor. A monitoring strip is applied to your forehead prior to anaesthesia. It is non invasive and painless.
Rare Side Effects with GA for Caesarean Section
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 of Spinal and Epidural Anaesthesia for Caesarean Section:
Sensation 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.
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 minimize 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:
- Drugs used during the regional anaesthetic, including epidural or spinal fentanyl, morphine or pethidine
- Injectable medication such as morphine or pethidine
- Analgesic tablets – Codeine/Panadol preparations, oxycodene and paracetamol, and anti inflammatory medication
Side effects of the pain relief may include: nausea, drowsiness or itchiness. These side effects will be treated as they occur.
Further information regarding caesarean sections can be found on the following web sites: