Spinal (spinal) anesthesia - a method in which a solution of a local anesthetic is injected into the space, located inside the spinal canal (between the vertebrae in подпаутинное space). Unlike epidural anesthesia is required puncture thick membrane surrounding the spinal cord: the needle is inserted somewhat deeper than with epidural anesthesia (epidural anesthesia is the introduction of the anesthetic in the lumbar region of the back between the vertebrae in the epidural space).
As an injection under spinal anesthesia make the lower end of the spinal cord, trauma of this body is possible.
3-7 minutes after administration of the drug occurs reversible blockade of nerve fibers responsible for the lower half of the body. Pregnant begins to feel the heat, and a numbness, reduces sensitivity, the muscles of the lower extremities. Spinal anaesthesia, compared with epidural or General, is easier in performance thanks to the ability to accurately determine the final reference point of insertion of the needle.Unlike epidural anesthesia during erroneous vnutrisosudistom dose of local anesthetic toxic reaction of the Central nervous system or cardiovascular system, as a rule, does not arise. In this regard, the use of spinal anesthesia is safer than an epidural.The main advantage of spinal anesthesia - faster, easier, less painful, requires a smaller dose anesthetics, has a more powerful effect on the nerves. When Photohem introduction of the spinal duration of the blockade is limited to the properties of the anesthetic (an adequate anesthesia for 2 hours, i.e. the interval, which is usually overlaps requirements in time for caesarean section).Cons spinal anesthesia is that it faster blocks the nerves that lead to hypotension (pronounced degree of reduction in blood pressure), and are often more severe than with epidural anesthesia.So you need to be careful for those who have a predisposition to reduced pressure due to some diseases. In such situations, if a woman is still wants to be awake at the time of caesarean, slow epidural preferable spinal.
ANESTHESIA WITH ARTIFICIAL LUNG VENTILATION (duration - as much as you want at a particular volume of intervention on average, 40 to 70 minutes). When :1. emergency caesarean sections ( mainly in cases of threatening the life of the mother or the child)2. There are contraindications to regional methods ( serious orthopedic violations, intolerance of drugs for local anesthesia )3. A large volume of surgical intervention ( such as rupture of the uterus)
1. requires little preparation time - that is convenient in the most urgent cases (such womb rupture ,eclampsia , profuznoe bleeding, acute asphyxia )2. lower risk of failure compared with regional methods (spinal ,epidural анестезиями)3. субьективно easier on the mother4. the depth of anesthesia easier to control5 . Well controlled the adequacy of pulmonary ventilation mothers (эндотрахеальном method of anesthesia ) 1. The risk of aspiration (vomiting and hit vomit into the respiratory tract)2. Increase in blood pressure and cardiac rhythm with the introduction of the throat tube laryngoscope3.. high percentage development of respiratory depression in the newbornINTRAVENOUS ANESTHESIA (duration 10 - 70 minutes depending on the type and dose of anesthetic)When:1. Obstetrical forceps , vacuum extractor2. Manual separation of the placenta , and the need for prompt intervention when the increment of the placenta3. The need in the curettage of the uterus ( instrumental scraping post-partum and post-abortion more than 5-6 weeks)4. Closure of the large gaps perineum ,vagina , cervix , sometimes even the walls of the rectum after childbirth5. Плодоразрушающие operations (tin and darkness ,but fortunately the greatest rarity in modern obstetrics). ADVANTAGES and CONS is almost the same as in endotrahealnom anaesthesia ,except complications and advantages associated with the use of respiration-anesthetic tube.
Regional anesthesia.When :1. In travail for the pain of contractions and treatment of certain violations of labor activity2. The most preferred method of anesthesia for cesarean section3. If the need for caesarean occurred in patients with already conducted epidural anesthesia in this case there is no need to do anesthesia again, or resort to General anaesthesia.
1. no need for intubation2. minimum risks of the development of hypertension (high blood pressure ) mothers that allows you to successfully use this type of anesthesia in parturient women with late гестозами ,accompanied by high blood pressure3. excluded irritation of the respiratory tract ,as well as the risk of infection through them4. minimal risk of depression newborn5. In kesarevom section of a woman in labour is conscious and can immediately see the newborn baby1. Requires more time training ( droppers ,introduction of depressants)2. great likelihood of a sharp drop in blood pressure in patients,loss of consciousness3. neurological complications, headaches , pain in the spine ,a violation of the sensitivity in the lower extremities , inflammatory processes)4. A very strict time limit after acute administration (spinal method)