Anesthesia for Cesarean Delivery

Abstract

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)