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Anesthesia for cesarean delivery

Heather Nixon, MD
Lisa Leffert, MD
Section Editor
David L Hepner, MD
Deputy Editor
Marianna Crowley, MD


Goals for anesthesia for cesarean delivery (CD) must include the comfort and safety of the parturient, and the well-being of the fetus and neonate. This topic will discuss the management of regional and general anesthesia for CD. Regional anesthesia techniques, adverse effects of neuraxial anesthesia, and neuraxial labor analgesia are reviewed separately. (See "Spinal anesthesia: Technique" and "Neuraxial analgesia for labor and delivery (including instrumented delivery)" and "Adverse effects of neuraxial analgesia and anesthesia for obstetrics" and "Epidural and combined spinal-epidural anesthesia: Techniques".)


We agree with the American Society of Anesthesiologists (ASA) Practice Guidelines for Obstetric Anesthesia, which recommend that parturients undergoing cesarean delivery (CD) should have a focused history and physical examination by an anesthesia provider [1].

History and physical examination – Gestational history, past medical history, allergies, and anesthetic history should be reviewed. At a minimum, the physical exam should include an assessment of the vital signs, airway, cardiac and respiratory systems, and lower back. In the case of a scheduled and non-urgent, non-emergent cesarean delivery, adequate preoperative fasting should be verified. (See "Preoperative fasting guidelines", section on 'Pregnancy'.)

The preoperative assessment for emergent CD should be as comprehensive as time permits.

Antenatal anesthesia consultation – It is reasonable to schedule an antenatal consultation with an anesthesiologist for patients at risk of complications due to preexisting conditions, even if cesarean delivery is not planned. Each parturient should be viewed as a potential candidate for operative delivery during labor, possibly on an emergent basis. Some of the indications for antenatal anesthesia consultation are shown in a table (table 1).  

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Literature review current through: Nov 2017. | This topic last updated: Nov 27, 2017.
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