Anesthesia for C-Section

Question 1

C-section is a

Answer 1

Team approach

Question 2

Best time to meet parturient

Answer 2

Meet the parturient as early as possible when they are admitted. Have them come in for pre-op visit if they are being induced

Question 3

• Learn as early as possible about:

Answer 3

• Airway difficulties
• Obesity
• Coagulopathies
• Congenital heart defects
• B/P issues
• Musculoskeletal issues
• Spinal fusion, Harrington rods, scoliosis, etc.

Question 4

Over the last 30 years:

Answer 4

• ↓use of GETA (went from 20-30% down to 5%)
• Epidurals were very popular in the 70’s and 80’s for C/S
• SAB are now considered the preferred anesthetic

Question 5

Anesthesia Complications During C/S

Answer 5

Sympathectomy (anesthetics , spinal)
• Bradycardia
• Nausea
• High spinal = respiratory paralysis (C3,4,5)
• Aspiration
• Difficult intubation
• LA toxicity= 
• Failed spinal
• Persistent neurological deficits

Question 6

C/S RED Flag Moments

Answer 6

• Hx of difficulty c/IV access
• Hx of headache lasting days after neuraxial anesthesia
• “I don’t feel so good, I think I’m going to be sick”
= HoTN until proven
otherwise!
• “I don’t feel like I’m getting enough air”
• “Are my fingers supposed to be tingling/numb?”

Question 7

Subarachnoid block

Answer 7

More common

Question 8

Decrease risk of headache (wet tap)

Answer 8

remove catheter

Question 9

Failed spinal is a

Answer 9

Complication

Question 10

MAP

Answer 10

Know how to calculate

Question 11

Diastolic is

Answer 11

Calculated

Question 12

Systolic is

Answer 12

r4eal

Question 13

MAP formula

Answer 13

(CO xSVR ) + CVP

Question 14

MAP 2nd formula

Answer 14

1/3 (systolic pressure-diastolic pressure ) + Diastolic pressure