The Current Role of General Anesthesia for Cesarean Delivery.
Cesarean delivery
General anesthesia
Maternal complications
Rapid sequence spinal anesthesia
Journal
Current anesthesiology reports
ISSN: 1523-3855
Titre abrégé: Curr Anesthesiol Rep
Pays: United States
ID NLM: 100888957
Informations de publication
Date de publication:
2021
2021
Historique:
accepted:
02
02
2021
pubmed:
2
3
2021
medline:
2
3
2021
entrez:
1
3
2021
Statut:
ppublish
Résumé
The use of general anesthesia for cesarean delivery has declined in the last decades due to the widespread utilization of neuraxial techniques and the understanding that neuraxial anesthesia can be provided even in urgent circumstances. In fact, the role of general anesthesia for cesarean delivery has been revisited, because despite recent devices facilitating endotracheal intubation and clinical algorithms, guiding anesthesiologists facing challenging scenarios, risks, and complications of general anesthesia at the time of delivery for both mother and neonate(s) remain significant. In this review, we will discuss clinical scenarios and risk factors associated with general anesthesia for cesarean delivery and address reasons why anesthesiologists should apply strategies to minimize its use. Unnecessary general anesthesia for cesarean delivery is associated with maternal complications, including serious anesthesia-related complications, surgical site infection, and venous thromboembolic events. Racial and socioeconomic disparities and low-resource settings are major contributing factors in the use of general anesthesia for cesarean delivery, with both maternal and perinatal mortality increasing when general anesthesia is provided. In addition, more significant maternal pain and higher rates of postpartum depression requiring hospitalization are associated with general anesthesia for cesarean delivery. Rates of general anesthesia for cesarean delivery have overall decreased, and while general anesthesia no longer is a contributing factor to anesthesia-related maternal deaths, further opportunities to reduce its use should be emphasized. Raising awareness in identifying situations and patients at risk to help avoid unnecessary general anesthesia remains crucial.
Identifiants
pubmed: 33642943
doi: 10.1007/s40140-021-00437-6
pii: 437
pmc: PMC7902754
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
18-27Informations de copyright
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021.
Déclaration de conflit d'intérêts
Competing InterestsThe authors do not have any potential conflicts of interest to disclose.
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