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Does epidural or spinal anaesthesia have any particular advantage over a general anaesthetic?
Most people will say yes. Firstly, it allows the mother to be awake and therefore witness the birth of her baby. She can hold the baby moments after delivery while the surgeons are continuing with their work.
Secondly, her partner is allowed to be by her side, if she is awake. This allows for the family atmosphere to be maintained at this very crucial and emotive time in their lives. It all augurs well for bonding.
Additionally, complications are fewer with regional anaesthesia, compared to general anaesthesia.
Why is spinal or epidural termed "regional" anaesthesia?
Because the effects are confined to only a particular section of the body and the upper half is left untouched.
What are the potential complications of regional anaesthesia?
The most common is a drop in blood pressure, and this is easily dealt with.
Occasionally, patients have post-spinal headache, which may last a few days and can be quite debilitating as it is felt with change of posture (usually from a flat position to a sitting or standing position). This can also be effectively dealt with.
Rarely, an abscess or blood-clot (haematoma) may form at the injection site. The symptoms are progressively worsening backache within a day or so of the procedure. It occurs with the epidural rather than spinal.
Occasionally, after starting the operation, it is discovered too late that the spinal or epidural is not fully effective and the patient is in some pain. There is then no choice but to resort to giving a general anaesthetic. This can be quite upsetting for someone who had wanted to stay awake. Fortunately, this is quite uncommon.
What are the potential complications of general anaesthesia?
"Aspiration" is the feared complication of a general anaesthetic. The unconscious patient undergoing the operation may vomit and breathe the vomited stuff into the airway. This can result in her being quite ill for days afterwards. This is why any mother who is to undergo a caesarean section will be given an injection of a drug to reduce the production of acid in the stomach and an antacid drink to neutralize the acid that is already there.
The other common complication is lowering blood pressure. As with the regional anaesthesia, general anaesthesia can lower the blood pressure.