How do I get anesthesia for a cesarean section?

  (1) Lower body anesthesia For cesarean section, the first choice is to use intraspinal anesthesia (lower body anesthesia), and most tertiary hospitals in China use combined lumbar epidural anesthesia, because this type of anesthesia has a fast onset, good anesthetic effect, and minimal impact on the mother and fetus. The mother is awake during the whole procedure.  During lumbar anesthesia and epidural anesthesia, it is very easy to cause hypotension (supine syndrome), and the mother may feel temporary chest tightness, dizziness, nausea, some may feel drifting all over, and some may even vomit. However, the anesthesiologist will deal with these situations in a timely manner, and the mother should not be nervous. The anesthesiologist will tilt the operating table to the left to reduce the pressure of the enlarged uterus on the inferior vena cava and increase the amount of blood returned to the heart. After the lower body is anesthetized, the mother has obvious numbness and feverish sensation in the lower limbs, cannot move or lift her legs, and feels that the lower half of her body is not her own. When the baby is delivered, the obstetrician will apply pressure on the upper abdomen to squeeze the baby out, and the mother will have temporary symptoms of chest tightness and breath-holding. Immediately after delivery, oxytocin will be added to the infusion to strengthen the contraction of the uterus to prevent postpartum hemorrhage, and the mother will feel her heart rate increase and her face become hot, which is the accompanying effect of oxytocin.  (2) General anesthesia However, in some special cases (such as contraindications to lumbar epidural anesthesia), general anesthesia may be more appropriate, and the obstetrician will consult with the anesthesiologist in this case. General anesthesia is an intravenous injection of anesthetic drugs, so these drugs may enter the fetus through the placental bloodstream. Although the amount of drugs used is less, a few newborns still require tracheal intubation after birth because of poorly established breathing. During pregnancy, pregnant women are more likely to have difficulty in intubation than others due to obesity and edema of the respiratory mucosa. Foreign studies have confirmed that pregnant women are more prone to misaspiration during general anesthesia, which affects the ventilation function.  To reduce the occurrence of misaspiration in pregnant women during anesthesia due to nausea and vomiting, doctors generally require pregnant women preparing for surgery to fast 6 to 8 hours prior to surgery. Therefore, pregnant women should consume liquid or semi-liquid food before delivery because this food is easy to digest and also easy to empty and requires a shorter waiting time. It is important to eat regularly and not to take a few bites now and then, so that the stomach is always in a non-emptying state and vomiting will easily occur once the surgery is performed.  (3) Local anesthesia In some cases, lateral incision is needed during vaginal delivery, for example, when the perineum is less elastic and the fetus is larger, in order to prevent severe perineal laceration; when some means are needed to assist labor, such as forceps and fetal suction, local anesthesia is needed. Usually only drugs are injected around the incision, and sometimes local nerve stem block anesthesia may be performed. This type of anesthesia is simple to operate and has few complications, but the duration of anesthesia is short and the analgesic effect is much less than that of intralesional anesthesia. Therefore, local anesthesia is not adequate for the anesthesia needed for cesarean section.