Felis ISSN 2398-2950

Anesthesia: for Cesarean section

Introduction

• Most major body systems undergo changes during pregnancy, which may have a significant impact on anesthetic management. The anesthetic technique chosen should ideally provide optimal maternal and fetal conditions to ensure optimal oxygen delivery with minimal neurological and cardiorespiratory depression of both the queen and kittens.
• Aims:
  • Safety of the queen should be first priority.
  • Good levels of arterial oxygen tension and optimal placental blood flow.
  • Good abdominal relaxation during surgery.
  • Production of viable, well-oxygenated neonates with minimal respiratory depresssion.
  • Rapid recovery from anesthesia, including good analgesia, to minimize disruption in the ability of the queen to care for the new-borns.
• The most important factors to consider when deciding upon the anesthetic protocol are:
  • The health status of the queen.
  • The viability of the kittens.
  • Emergency vs 'elective' procedure.
  • Provision of analgesia to the queen.
  • Familiarity with the anesthetic technique.
  • Available drugs.
• Epidural anesthesia Anesthesia: epidural alone is not a viable alternative to general anesthesia General anesthesia: overview, as heavy sedation is necessary to ensure a compliant patient. This may have more detrimental effects on the fetus(es) than a well administered general anesthetic. However, lumbar epidural analgesia/anesthesia providing both analgesia and relaxation of abdominal skeletal musculature may enable an absolute minimum of inhalational maintenance agent to be used, thus reducing the inevitable cardiovascular and respiratory system depression produced by the general anesthetic agent to a minimum.

Physiology of pregnancy

Pre-anesthetic considerations

Fluid therapy

Analgesia

Recovery