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Re: Anesthesia for Emergency CesareanFrom: Braun, R. Daniel (rbraun@iupui.edu)Tue Mar 23 04:25:23 1999
I have personally done two C/S's under local anesthesia. They were both for persistent prolonged severe decels and anesthesia was not in house. In both cases the patient was quite vocal about the ineffectiveness of the anesthesia. As soon as the baby was delivered, we waited to deliver the placenta and repair the uterus until anesthesia arrived and put her to sleep. Both were done in the O.R. I would be very hesitant to do any C/S other than Postmortem in the labor room. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN -----Original Message----- From: ainsron@msn.com [SMTP:ainsron@msn.com] Sent: Monday, March 22, 1999 8:43 PM To: Multiple recipients of list Subject: Anesthesia for Emergency Cesarean Is there any consensus on what is the safest anesthesia for a cesarean section when a truly emergent need arises and no room or anesthesiologist is readily available (within the ACOG 30 minute rule, or more importantly during the 17 minutes it takes before irreversible brain damage)? It has been suggested that a cesarean section in a L&D room under local infiltration would be the safest option. Personally, I've used local to supplement patchy epidurals, never by itself and even that has not been a great experience. Frankly, I don't relish the idea of doing a C/S under local and can't see it saving much time, plus I am concerned about toxicity of large amounts of local. I am trained in regional anesthesia and do most of my own epidurals and intrathecals in labor. Although I do regionals in labor with only BP monitoring, I would not want to do a cesarean section without an EKG monitor and pulse oximeter and we don't have that available in our Ob unit. What's the practice in other hospitals? -- Ronald E. Ainsworth, MD, FACOG Paradise, CA, Private Practice 20 yrs.
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