Editing Caesarean section (section)

===Anesthesia===
Both [[general anesthesia|general]] and [[regional anesthesia|regional anaesthesia]] ([[spinal anaesthesia|spinal]], [[epidural]] or [[combined spinal and epidural anaesthesia]]) are acceptable for use during caesarean section. Evidence does not show a difference between regional anaesthesia and general anaesthesia concerning major outcomes in the mother or baby.<ref name="Afolabi">{{cite journal | vauthors = Afolabi BB, Lesi FE | title = Regional versus general anaesthesia for caesarean section | journal = The Cochrane Database of Systematic Reviews | volume = 10 | pages = CD004350 | date = October 2012 | pmid = 23076903 | doi = 10.1002/14651858.CD004350.pub3 | pmc = 12009660 }}</ref> Regional anaesthesia may be preferred as it allows the mother to be awake and interact immediately with her baby.<ref name=Hawkins>{{cite journal | vauthors = Hawkins JL, Koonin LM, Palmer SK, Gibbs CP | title = Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990 | journal = Anesthesiology | volume = 86 | issue = 2 | pages = 277–284 | date = February 1997 | pmid = 9054245 | doi = 10.1097/00000542-199702000-00002 | s2cid = 21467445 | doi-access = free }}</ref> Compared to general anaesthesia, regional anaesthesia is better at preventing [[persistent postoperative pain]] 3 to 8 months after caesarean section.<ref>{{cite journal | vauthors = Weinstein EJ, Levene JL, Cohen MS, Andreae DA, Chao JY, Johnson M, Hall CB, Andreae MH | title = Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children | journal = The Cochrane Database of Systematic Reviews | volume = 6 | issue = 6 | pages = CD007105 | date = June 2018 | pmid = 29926477 | pmc = 6377212 | doi = 10.1002/14651858.CD007105.pub4 }}</ref> Other advantages of regional anesthesia may include the absence of typical risks of general anesthesia: [[pulmonary aspiration]] (which has a relatively high incidence in patients undergoing anesthesia in late pregnancy) of gastric contents and [[Esophagus|esophageal]] [[intubation]].<ref name=Afolabi/> One trial found no difference in satisfaction when general anaesthesia was compared with either spinal anaesthesia.<ref name="Afolabi" />

Regional anaesthesia is used in 95% of deliveries, with spinal and combined spinal and epidural anaesthesia being the most commonly used regional techniques in scheduled caesarean section.<ref name="Bucklin">{{cite journal | vauthors = Bucklin BA, Hawkins JL, Anderson JR, Ullrich FA | title = Obstetric anesthesia workforce survey: twenty-year update | journal = Anesthesiology | volume = 103 | issue = 3 | pages = 645–653 | date = September 2005 | pmid = 16129992 | doi = 10.1097/00000542-200509000-00030 | doi-access = free }}</ref> Regional anaesthesia during caesarean section is different from the [[analgesia]] (pain relief) used in labor and vaginal delivery.<ref>{{cite journal | vauthors = Wang SC, Pan PT, Chiu HY, Huang CJ | title = Neuraxial magnesium sulfate improves postoperative analgesia in Cesarean section delivery women: A meta-analysis of randomized controlled trials | journal = Asian Journal of Anesthesiology | volume = 55 | issue = 3 | pages = 56–67 | date = September 2017 | pmid = 28797894 | doi = 10.1016/j.aja.2017.06.005 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Lavoie A, Toledo P | title = Multimodal postcesarean delivery analgesia | journal = Clinics in Perinatology | volume = 40 | issue = 3 | pages = 443–455 | date = September 2013 | pmid = 23972750 | doi = 10.1016/j.clp.2013.05.008 | series = Pain Management in the Peripartum Period }}</ref><ref>{{cite journal | vauthors = Nardi N, Campillo-Gimenez B, Pong S, Branchu P, Ecoffey C, Wodey E | title = [Chronic pain after cesarean: Impact and risk factors associated] | language = fr | journal = Annales Françaises d'Anesthésie et de Réanimation | volume = 32 | issue = 11 | pages = 772–778 | date = November 2013 | pmid = 24138769 | doi = 10.1016/j.annfar.2013.08.007 }}</ref> The pain that is experienced because of surgery is greater than that of labor and therefore requires a more intense [[nerve block]].

General anesthesia may be necessary because of specific risks to the mother or child. Patients with heavy, uncontrolled bleeding may not tolerate the hemodynamic effects of regional anesthesia. General anesthesia is also preferred in very urgent cases, such as severe fetal distress when there is no time to perform a regional anesthesia.