General Anesthesia for Cesarean Section
By Richard C. Month, M.D., FASA
Some patients will go to sleep for their cesarean sections. Why does this happen, what does it feel like, and what are the risks?
General anesthesia is standard “sleep” anesthesia, and is what most people think of when they hear “Anesthesia.” You will get a mixture of medicines (both inhaled and through the vein) that will make you fall completely asleep. You will feel and remember nothing during your surgery.
Only when we need to. Most C-sections are done with epidural or spinal anesthesia that make you very numb but allow you to be awake to deliver your baby. In fact, less than 5 out of every 100 C-sections in the United States are done with general anesthesia, though more are done in some countries.
There are a few reasons why we may decide to do general anesthesia for your C-section. These reasons may make epidural or spinal anesthesia less safe than normal. Some of them are:
- Brain or nerve problems, like brain tumors and certain kinds of spinal cord problems.
- Bleeding problems, like when your blood does not clot well, or when you’re taking certain blood thinning medications.
- Spine problems and some spine surgeries, that may make placing epidurals or spinals difficult or impossible.
- Problems with epidural or spinal anesthesia. If, for some reason, you do not get as numb as you need to be with an epidural or spinal, your anesthesiologist and you may decide to do general anesthesia.
- Any emergency during labor, where the baby must be delivered very quickly and there is not enough time to do epidural or spinal anesthesia.
There are other reasons why general anesthesia may be a better kind of anesthesia for your C-section. The decision to do general anesthesia will be decided by you and your anesthesiologist.
General anesthesia, while safe, does have higher risks in pregnant women. In addition, any medicines we give to you may go to your baby, so there is a chance your baby may be sleepy when born and may need some help breathing. If this happens, it almost always improves very quickly after birth. Also, if you are asleep, you will not remember the birth. For these reasons, we avoid general anesthesia for pregnant patients unless we need to do it.
You will come to the operating room and you will lie on an operating table. We will connect monitors that will tell us your vital signs (blood pressure, pulse, oxygen levels) during surgery. While we do this, you will breathe pure oxygen from a mask. The obstetricians will clean your belly with sterile soap and a drape will be put up to make sure it stays sterile. Once the obstetricians are ready to begin surgery, you will go to sleep. After you are asleep, a breathing tube will be placed in your windpipe to help you breathe and help give you the inhaled medicine. The breathing tube is removed at the end of surgery, while you are waking up.
Your pain will usually be treated with pain medicines given either by mouth or through the vein.