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Re: C/S Under Local AnesthesiaFrom: Jane Helwig, MD (jane@seasonedsystems.com)Sun Feb 6 08:05:50 2000
Gerald, Here are Gil Webb's directions (I may have posted them last year). I agree with Dan and Joe--not an experience I want to repeat. As we have discussed, taking the time to get reasonably good local anesthesia negates the purpose of doing the procedure, which is to get the baby out ASAP. Agree with waiting for anesthesia before repairing the uterus although do deliver the placenta to reduce blood loss. (I know El is going to tell us just to put in a quick spinal, which I don't have privileges for.) May no one ever need these instructions... Cesarean section under local -- Gil Webb, MD lecture at California Pacific Medical Center 2/27/95 1. Use 1/2% lidocaine 2. Keep dosage under 100 cc 3. Only works with vertical incision 4. Remember the nerves go up and out over the abd wall 5. Make three wheals at 3 points in midline, 10 cc each, injecting as a fan. 6. Put 2cc in each little injection in fascia--don't stick the uterus. 7. Inject q1-1/2 to 2cm down each side of the midline 8. Inject about 5cc at the pubic tubercle 9. Inject the peritoneum, a cc or so down each side q1-2 cm 10. Use hands as retractors, then inject under the anterior abd wall, 5cc --aspirate--, can then place retractors. 11. No need to inject uterus. 12. Make incision in uterus long enough. 13. Don't deliver the uterus.
At Sat, 5 Feb 2000, Gerald P. Rodriguez wrote:
>
-- Jane Helwig, MD, FACOG Private practice Nassawadox, VA
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