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Chapter 15 - General anesthesia for cesarean delivery
Book chapter

Chapter 15 - General anesthesia for cesarean delivery

Ketan Parikh and Shilpa Kasodekar
A Quick Reference to Obstetric Anesthesia, pp.185-192
Academic Press
2025
DOI: 10.1016/B978-0-443-21917-7.00035-5

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Abstract

The use of general anesthesia (GA) for cesarean delivery has declined in the last decades due to the widespread utilization of neuraxial anesthesia (NA). NA, such as rapid-sequence spinal anesthesia, can be provided even in urgent circumstances. GA is much safer due to widespread availability and advances in upper airway devices such as video-laryngoscopes and second-generation LMAs as well as clear guidelines on difficult airway management. Videolaryngoscope should be used as the first-line laryngoscope to maximize the success rate of intubation during rapid-sequence induction (RSI) in obstetric practice. Desaturation during RSI in the parturient can be avoided by an effective preoxygenation technique, gentle bag-mask ventilation, and apneic oxygenation techniques. Emphasis on preanesthesia airway assessment and adherence to ASA NPO guidelines, whenever possible, will ensure not only adequate readiness on the part of anesthesiologist but also enhance maternal safety. The use of Bispectral Index monitoring is highly recommended to reduce the possibility of intraoperative awareness during GA for CS.
aspiration prophylaxis cesarean section General anesthesia NPO guidelines rapid-sequence induction

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