Can general anesthesia for cesarean delivery be completely avoided? An anesthetic perspective

Abstract

The dramatic increase in the rate of cesarean deliveries worldwide has focused attention on the uncommon but present risk of maternal mortality associated with anesthesia. The relative risk of maternal death is greater with general versus neuraxial (i.e., spinal, epidural, combined spinal-epidural and dural puncture epidural) techniques. As a consequence, neuraxial techniques are the preferred option. Failures in intubation, ventilation and extubation, as well as depression of postdelivery ventilation, represent risks of general anesthesia. Although these risks, and the use of general anesthesia, cannot be eliminated, various strategies can be employed to minimize these outcomes.