Describe the regional anesthetic techniques that can be employed for cesarean section

Describe the regional anesthetic techniques that can be employed for cesarean section.

Regional anesthetic techniques include spinal and epidural anesthesia. During regional anesthesia the mother remains awake during the delivery, thereby significantly decreasing the risk of maternal aspiration associated with general anesthesia. Regional anesthesia also minimizes the potential for depression of the neonate from maternal drug administration. Because regional anesthesia is safer than general anesthesia for both the mother and the fetus, it should be used for all elective cesarean deliveries.

Relatively few absolute contraindications exist to regional anesthesia. These include infection at the injection site, severe hypovolemia, raised intracranial pressure, patient refusal, and coagulation abnormalities. Relative contraindications include neurologic disease such as multiple sclerosis, history of back surgery or back pain, and systemic infection.

Spinal anesthesia provides reliable and rapid anesthesia. In certain urgent situations, spinal anesthesia can even be used in place of general anesthesia. Disadvantages of spinal anesthesia include a potential for hypotension, inability to control the spread of anesthesia, limited duration and possibility of postdural puncture headache.

Continuous epidural anesthesia allows for multiple repeat doses of local anesthetic, which offers better control over anesthetic spread, mitigates against precipitous drops in blood pressure, and allows almost unlimited duration of anesthesia. Epidural anesthesia can be used for both labor and cesarean delivery. Compared with spinal anesthesia, the major disadvantages of epidural anesthesia are the time required to place a needle or catheter and the potential for local anesthetic toxicity.