Obstetric Anesthesia Considerations I 2025-Cesarean Delivery

Video Transcription

Video Summary

The presentation by Tom Mingus focuses on anesthesia considerations during cesarean delivery, specifically comparing neuraxial (spinal, epidural, and combined spinal-epidural) and general anesthesia approaches. The primary neuraxial technique discussed is the intrathecal (spinal) block, known for its rapid onset and high success rate, although it is a single-shot method with variable duration. Epidurals, often used for laboring patients converted to surgical anesthetic, allow for adjustable dosing and prolonged blockade but require larger volumes and have slower onset compared to spinals.<br /><br />A combined spinal-epidural (CSE) merges benefits of both, offering initial dense block with the potential for prolonged anesthesia. Challenges with both methods include potential failures and complications like high spinal or hypotension, which can affect fetal outcomes. General anesthesia, though sometimes necessary due to maternal or procedural factors, carries higher risks, including difficult airway and increased fetal distress. Effective anesthesia management requires preparedness, proper dosing, and consideration of maternal factors like height and complications such as preeclampsia. The presentation also delves into managing anesthesia-induced nausea, fluid management, and the importance of a skilled anesthesia provider in emergency scenarios.

Keywords

anesthesia

cesarean delivery

neuraxial techniques

spinal block

epidural

general anesthesia

maternal factors