Anaesthesia for caesarean section

Quality and choice in anaesthesia for caesarean section have significantly improved over the last two decades. During this time, general anaesthesia u sage has decreased to the point where, in some centres, it is an occasional ly used technique for severe fetal distress. This change in practice may ha ve been responsible for the fall in anaesthetic deaths in pregnant women th at has occurred over the same period. The boom in regional anaesthesia has improved the aesthetics of childbirth by caesarean section, women's peri-op erative comfort, and post-operative analgesia. It has, however, introduced new problems, such as delays in inducing anaesthesia in emergency situation s, post-operative immobility and urinary retention. The increase in anaesth etic choices has led to inconsistencies in practice between individual anae sthetists, and between regions and nations. It is therefore impossible for obstetricians to make assumptions about the impact of anaesthesia on their patients. Where possible, anaesthetic protocols and guidelines should exist in every centre, with obstetricians clearly informed of relevant features. Such an approach will prevent inconsistent advice being given to patients and dangerous mistakes occurring. With every aspect of maternity care, a mu ltidisciplinary team approach is in patients' best interests, and anaesthes ia for caesarean section is no exception.