Skip to main content
SpringerLink
Log in

Spinal Anesthesia for Cesarean Section

  • Chapter
  • First Online:
Book cover Anesthesia for Cesarean Section

  • 1397 Accesses

Abstract

The rates of cesarean section have significantly increased worldwide over the past three decades. The choice of anesthetic depends on a number of factors: maternal, fetal, surgical, and anesthetic. Neuraxial techniques are the preferred method of anesthesia reducing morbidity and mortality for parturients and allowing maternal bonding with the neonate postoperatively. Spinal anesthesia is technically simple to perform producing a rapid onset and dense block with a predictable offset. In this chapter, we will review the advantages and disadvantages of spinal anesthesia, the evidence behind the technique itself and the commonly used medications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985–2003. Anesthesiology. 2007;106(6):1096–104.

    Article  PubMed  Google Scholar 

  2. Paech MJ, Scott KL, Clavisi O, Chua S, McDonnell N. ANZCA trials group. A prospective study of awareness and recall associated with general anaesthesia for caesarean section. Int J Obstet Anesth. 2008;17(4):298–303.

    Article  CAS  PubMed  Google Scholar 

  3. Purva M, Russell IF, Kinsella M. Caesarean section anaesthesia: a technique and failure rate. In: Raising the Standard: a compendium of audit recipes. Royal College of Anaesthetists; 2012. p. 220–1.

    Google Scholar 

  4. Armstrong S, Walters M, Cheesman K. Neuraxial anaesthesia for caesarean delivery. In: Clarke V, Fernando R, Van de Velde M, editors. Oxford textbook of obstetric anaesthesia. Oxford: Oxford University Press; 2016.

    Google Scholar 

  5. Riley ET, Cohen SE, Macario A, Desai JB, Ratner EF. Spinal versus epidural anesthesia for cesarean section: a comparison of time efficiency, costs, charges, and complications. Anesth Analg. 1995;80(4):709–12.

    CAS  PubMed  Google Scholar 

  6. Garry M, Davies S. Failure of regional blockade for caesarean section. Int J Obstet Anesth. 2002;11(1):9–12.

    Article  CAS  PubMed  Google Scholar 

  7. Tsen L.. Anaesthesia for cesarean delivery. In: Chestnut DH, editors. Chestnut's obstetric anesthesia: principles and practice. 2014.

    Google Scholar 

  8. Kuhnert BR, Philipson EH, Pimental R, Kuhnert PM, Zuspan KJ, Syracuse CD. Lidocaine disposition in mother, fetus, and neonate after spinal anesthesia. Anesth Analg. 1986;65(2):139–44.

    Article  CAS  PubMed  Google Scholar 

  9. Kuhnert BR, Zuspan KJ, Kuhnert PM, Syracuse CD, Brown DE. Bupivacaine disposition in mother, fetus, and neonate after spinal anesthesia for cesarean section. Anesth Analg. 1987;66(5):407–12.

    Article  CAS  PubMed  Google Scholar 

  10. Cook TM, Counsell D, Wildsmith JAW. Major complications of central neuraxial block: report on the third national audit project of the royal college of anaesthetists. Br J Anaesth. 2009;102(2):179–90.

    Article  CAS  PubMed  Google Scholar 

  11. WHO guidelines for safe surgery 2009: Safe surgery saves lives. World Health Organisation. 2009.

    Google Scholar 

  12. de Vries EN, Prins HA, Crolla RMPH, den Outer AJ, van Andel G, van Helden SH, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med. 2010;363(20):1928–37.

    Article  PubMed  Google Scholar 

  13. Department of health (DOH). Uniforms and workwear: An evidence base for developing local policy. DOH 2007. Accessed Mar 2014.

    Google Scholar 

  14. Benhamou D, Bouaziz H, Chassard D, Ducloy J-C, Fuzier V, Laffon M, et al. Anaesthetic practices for scheduled caesarean delivery: a 2005 french national survey. Eur J Anaesthesiol. 2009;26(8):694–700.

    Article  PubMed  Google Scholar 

  15. Checketts MR. Wash & go—but with what? Skin antiseptic solutions for central neuraxial block. Anaesthesia. 2012;67(8):819–22.

    Article  CAS  PubMed  Google Scholar 

  16. Malhotra S, Dharmadasa A, Yentis SM. One vs two applications of chlorhexidine/ethanol for disinfecting the skin: implications for regional anaesthesia. Anaesthesia. 2011;66(7):574–8.

    Article  CAS  PubMed  Google Scholar 

  17. Killeen T, Kamat A, Walsh D, Parker A, Aliashkevich A. Severe adhesive arachnoiditis resulting in progressive paraplegia following obstetric spinal anaesthesia: a case report and review. Anaesthesia. 2012;67(12):1386–94.

    Article  CAS  PubMed  Google Scholar 

  18. Armstrong S, Fernando R, Tamilselvan P, Stewart A, Columb M. The effect of serial in vitro haemodilution with maternal cerebrospinal fluid and crystalloid on thromboelastographic (TEG(®) ) blood coagulation parameters, and the implications for epidural blood patching. Anaesthesia. 2015;70(2):135–41.

    Article  CAS  PubMed  Google Scholar 

  19. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Can J Anaesth. 2003;50(5):460–9.

    Article  PubMed  Google Scholar 

  20. Van de Velde M, Schepers R, Berends N, Vandermeersch E, De Buck F. Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric anaesthesia department. Int J Obstet Anesth. 2008;17(4):329–35.

    Article  CAS  PubMed  Google Scholar 

  21. Stocks GM, Wooller DJ, Young JM, Fernando R. Postpartum headache after epidural blood patch: investigation and diagnosis. Br J Anaesth. 2000;84(3):407–10.

    Article  CAS  PubMed  Google Scholar 

  22. Tourtellotte WW, Henderson WG, Tucker RP, Walker JE, Kokman E. A randomized, double-blind clinical trial comparing the 22 versus 26 gauge needle in the production of the post-lumbar puncture syndrome in normal individuals. Headache: J Head Face Pain. 1972;12(2):73–8.

    Article  CAS  Google Scholar 

  23. Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003;91(5):718–29.

    Article  CAS  PubMed  Google Scholar 

  24. Reynolds F. Damage to the conus medullaris following spinal anaesthesia. Anaesthesia. 2001;56(3):238–47.

    Article  CAS  PubMed  Google Scholar 

  25. Broadbent CR, Maxwell WB, Ferrie R, Wilson DJ, Gawne-Cain M. Ability of anaesthetists to identify a marked lumbar interspace. (Nuffield department of anaesthetics, john Radcliffe hospital, oxford, United Kingdom). Anaesthesia. 2000;55:1122–6. Pain Practice 2001;1(2):199–200

    Article  CAS  PubMed  Google Scholar 

  26. Lee AJ, Ranasinghe JS, Chehade JM, Arheart K, Saltzman BS, Penning DH, Birnbach DJ. Ultrasound assessment of the vertebral level of the intercristal line in pregnancy. Anesth Analg. 2011;113(3):559–64.

    PubMed  Google Scholar 

  27. Shaikh F, Brzezinski J, Alexander S, Arzola C, Carvalho JCA, Beyene J, Sung L. Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis. BMJ. 2013;346:f1720.

    Article  PubMed  Google Scholar 

  28. Armstrong S, Fernando R, Columb M, Jones T. Cardiac index in term pregnant women in the sitting, lateral, and supine positions: an observational, crossover study. Anesth Analg. 2011;113(2):318–22.

    Article  PubMed  Google Scholar 

  29. Yun EM, Marx GF, Santos AC. The effects of maternal position during induction of combined spinal-epidural anesthesia for cesarean delivery. Anesth Analg. 1998;87(3):614–8.

    CAS  PubMed  Google Scholar 

  30. Inglis A, Daniel M, McGrady E. Maternal position during induction of spinal anaesthesia for caesarean section. A comparison of right lateral and sitting positions. Anaesthesia. 1995;50(4):363–5.

    Article  CAS  PubMed  Google Scholar 

  31. Hallworth SP, Fernando R, Columb MO, Stocks GM. The effect of posture and baricity on the spread of intrathecal bupivacaine for elective cesarean delivery. Anesth Analg. 2005;100(4):1159–65.

    Article  PubMed  Google Scholar 

  32. Heng Sia AT, Tan KH, Sng BL, Lim Y, Chan ESY, Siddiqui FJ. Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery. Anesth Analg. 2015;120(1):132–40.

    Article  PubMed  Google Scholar 

  33. Ralston DH, Shnider SM, DeLorimier AA. Effects of equipotent ephedrine, metaraminol, mephentermine, and methoxamine on uterine blood flow in the pregnant ewe. Anesthesiology. 1974;40(4):354–70.

    Article  CAS  PubMed  Google Scholar 

  34. Lee A, Ngan Kee WD, Gin T. A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg. 2002;94(4):920–6. table of contents

    Article  CAS  PubMed  Google Scholar 

  35. Wollman SB, Marx GF. Acute hydration for prevention of hypotension of spinal anesthesia in parturients. Anesthesiology. 1968;29(2):374–80.

    Article  CAS  PubMed  Google Scholar 

  36. Pouta AM, Karinen J, Vuolteenaho OJ, Laatikainen TJ. Effect of intravenous fluid preload on vasoactive peptide secretion during caesarean section under spinal anaesthesia. Anaesthesia. 1996;51(2):128–32.

    Article  CAS  PubMed  Google Scholar 

  37. Ueyama H, He YL, Tanigami H, Mashimo T, Yoshiya I. Effects of crystalloid and colloid preload on blood volume in the parturient undergoing spinal anesthesia for elective cesarean section. Anesthesiology. 1999;91(6):1571–6.

    Article  CAS  PubMed  Google Scholar 

  38. Cyna AM, Andrew M, Emmett RS, Middleton P, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2006;4:CD002251.

    Google Scholar 

  39. Bajwa SJS, Kulshrestha A, Jindal R. Co-loading or pre-loading for prevention of hypotension after spinal anaesthesia! A therapeutic dilemma. Anesth Essays Res. 2013;7(2):155–9.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Chanimov M, Gershfeld S, Cohen ML, Sherman D, Bahar M. Fluid preload before spinal anaesthesia in caesarean section: the effect on neonatal acid-base status. Eur J Anaesthesiol. 2006;23(8):676–9.

    Article  CAS  PubMed  Google Scholar 

  41. Tawfik MM, Hayes SM, Jacoub FY, Badran BA, Gohar FM, Shabana AM, et al. Comparison between colloid preload and crystalloid co-load in cesarean section under spinal anesthesia: a randomized controlled trial. Int J Obstet Anesth. 2014;23(4):317–23.

    Article  CAS  PubMed  Google Scholar 

  42. Khaw KS, Ngan Kee WD, Wong M, Ng F, Lee A. Spinal ropivacaine for cesarean delivery: a comparison of hyperbaric and plain solutions. Anesth Analg. 2002;94(3):680–5. table of contents

    Article  CAS  PubMed  Google Scholar 

  43. Vercauteren MP, Coppejans HC, Hoffmann VL, Saldien V, Adriaensen HA. Small-dose hyperbaric versus plain bupivacaine during spinal anesthesia for cesarean section. Anesth Analg. 1998;86(5):989–93.

    Article  CAS  PubMed  Google Scholar 

  44. Gautier P, De Kock M, Huberty L, Demir T, Izydorczic M, Vanderick B. Comparison of the effects of intrathecal ropivacaine, levobupivacaine, and bupivacaine for caesarean section. Br J Anaesth. 2003;91(5):684–9.

    Article  CAS  PubMed  Google Scholar 

  45. Oğün CO, Kirgiz EN, Duman A, Okesli S, Akyürek C. Comparison of intrathecal isobaric bupivacaine-morphine and ropivacaine-morphine for caesarean delivery. Br J Anaesth. 2003;90(5):659–64.

    Article  PubMed  Google Scholar 

  46. Lanz E, Schmitz D. No effect of injection volume on sensory and motor blockade in isobaric spinal anesthesia. Reg Anaesth. 1990;13(7):153–8.

    CAS  PubMed  Google Scholar 

  47. Russell IF. Spinal anesthesia for cesarean delivery with dilute solutions of plain bupivacaine: the relationship between infused volume and spread. Reg Anesth. 1991;16(3):130–6.

    CAS  PubMed  Google Scholar 

  48. Russell IF. At caesarean section under regional anaesthesia, it is essential to test sensory block with light touch before allowing surgery to start. Int J Obstet Anesth. 2006;15(4):294–7.

    Article  CAS  PubMed  Google Scholar 

  49. Teoh WHL, Thomas E, Tan HM. Ultra-low dose combined spinal-epidural anesthesia with intrathecal bupivacaine 3.75 mg for cesarean delivery: a randomized controlled trial. Int J Obstet Anesth. 2006;15(4):273–8.

    Article  CAS  PubMed  Google Scholar 

  50. Kestin IG. Spinal anaesthesia in obstetrics. Br J Anaesth. 1991;66(5):596–607.

    Article  CAS  PubMed  Google Scholar 

  51. Hartwell BL, Aglio LS, Hauch MA, Datta S. Vertebral column length and spread of hyperbaric subarachnoid bupivacaine in the term parturient. Reg Anesth. 1991;16(1):17–9.

    CAS  PubMed  Google Scholar 

  52. Norris MC. Height, weight, and the spread of subarachnoid hyperbaric bupivacaine in the term parturient. Anesth Analg. 1988;67(6):555–8.

    Article  CAS  PubMed  Google Scholar 

  53. Ozkan Seyhan T, Orhan-Sungur M, Basaran B, Savran Karadeniz M, Demircan F, Xu Z, Sessler DI. The effect of intra-abdominal pressure on sensory block level of single-shot spinal anesthesia for cesarean section: an observational study. Int J Obstet Anesth. 2015;24(1):35–40.

    Article  CAS  PubMed  Google Scholar 

  54. Carvalho B, Collins J, Drover DR, Atkinson Ralls L, Riley ET. ED(50) and ED(95) of intrathecal bupivacaine in morbidly obese patients undergoing cesarean delivery. Anesthesiology. 2011;114(3):529–35.

    Article  CAS  PubMed  Google Scholar 

  55. Ginosar Y, Mirikatani E, Drover DR, Cohen SE, Riley ET. ED50 and ED95 of intrathecal hyperbaric bupivacaine coadministered with opioids for cesarean delivery. Anesthesiology. 2004;100(3):676–82.

    Article  CAS  PubMed  Google Scholar 

  56. Carvalho B, Durbin M, Drover DR, Cohen SE, Ginosar Y, Riley ET. The ED50 and ED95 of intrathecal isobaric bupivacaine with opioids for cesarean delivery. Anesthesiology. 2005;103(3):606–12.

    Article  CAS  PubMed  Google Scholar 

  57. Bryson GL, Macneil R, Jeyaraj LM, Rosaeg OP. Small dose spinal bupivacaine for cesarean delivery does not reduce hypotension but accelerates motor recovery. Can J Anaesth. 2007;54(7):531–7.

    Article  PubMed  Google Scholar 

  58. Choi DH, Ahn HJ, Kim MH. Bupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000;25(3):240–5.

    CAS  PubMed  Google Scholar 

  59. Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson EW, Martin H. Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section. Anesth Analg. 1997;85(6):1288–93.

    Article  CAS  PubMed  Google Scholar 

  60. Cousins MJ, Mather LE. Intrathecal and epidural administration of opioids. Anesthesiology. 1984;61(3):276–310.

    Article  CAS  PubMed  Google Scholar 

  61. Bernards CM, Hill HF. Physical and chemical properties of drug molecules governing their diffusion through the spinal meninges. Anesthesiology. 1992;77(4):750–6.

    Article  CAS  PubMed  Google Scholar 

  62. Scrutton M, Kinsella SM. The immediate caesarean section: rapid-sequence spinal and risk of infection. Int J Obstet Anesth. 2003;12(2):144.

    Article  Google Scholar 

  63. Armstrong S, Stocks G. Postoperative analgesia after caesarean delivery. In: Clarke V, Fernando R, Van de Velde M, editors. Oxford textbook of obstetric anaesthesia. Oxford: Oxford University Press; 2016.

    Google Scholar 

  64. Dahl JB, Jeppesen IS, Jørgensen H, Wetterslev J, Møiniche S. Intraoperative and postoperative analgesic efficacy and adverse effects of intrathecal opioids in patients undergoing cesarean section with spinal anesthesia: a qualitative and quantitative systematic review of randomized controlled trials. Anesthesiology. 1999;91(6):1919–27.

    Article  CAS  PubMed  Google Scholar 

  65. Palmer CM, Voulgaropoulos D, Alves D. Subarachnoid fentanyl augments lidocaine spinal anesthesia for cesarean delivery. Reg Anesth. 1995;20(5):389–94.

    CAS  PubMed  Google Scholar 

  66. Manullang TR, Viscomi CM, Pace NL. Intrathecal fentanyl is superior to intravenous ondansetron for the prevention of perioperative nausea during cesarean delivery with spinal anesthesia. Anesth Analg. 2000;90(5):1162–6.

    Article  CAS  PubMed  Google Scholar 

  67. Courtney MA, Bader AM, Hartwell B, Hauch M, Grennan MJ, Datta S. Perioperative analgesia with subarachnoid sufentanil administration. Reg Anesth. 1992;17(5):274–8.

    CAS  PubMed  Google Scholar 

  68. Lee JH, Chung KH, Lee JY, Chun DH, Yang HJ, Ko TK, Yun WS. Comparison of fentanyl and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean section. Korean J Anesthesiol. 2011;60(2):103–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Ngiam SK, Chong JL. The addition of intrathecal sufentanil and fentanyl to bupivacaine for caesarean section. Singap Med J. 1998;39(7):290–4.

    CAS  Google Scholar 

  70. Bromage PR, Camporesi EM, Durant PA, Nielsen CH. Rostral spread of epidural morphine. Anesthesiology. 1982;56(6):431–6.

    Article  CAS  PubMed  Google Scholar 

  71. Palmer CM, Emerson S, Volgoropolous D, Alves D. Dose-response relationship of intrathecal morphine for postcesarean analgesia. Anesthesiology. 1999;90(2):437–44.

    Article  CAS  PubMed  Google Scholar 

  72. Wong JY, Carvalho B, Riley ET. Intrathecal morphine 100 and 200 μg for post-cesarean delivery analgesia: a trade-off between analgesic efficacy and side effects. Int J Obstet Anesth. 2013;22(1):36–41.

    Article  CAS  PubMed  Google Scholar 

  73. Glynn CJ, Mather LE, Cousins MJ, Wilson PR, Graham JR. Spinal narcotics and respiratory depression. Lancet. 1979;2(8138):356–7.

    Article  CAS  PubMed  Google Scholar 

  74. Scott DB, McClure J. Selective epidural analgesia. Lancet. 1979;1(8131):1410–1.

    Article  CAS  PubMed  Google Scholar 

  75. Cohen SE, Labaille T, Benhamou D, Levron JC. Respiratory effects of epidural sufentanil after cesarean section. Anesth Analg. 1992;74(5):677–82.

    Article  CAS  PubMed  Google Scholar 

  76. Negre I, Gueneron JP, Ecoffey C, Penon C, Gross JB, Levron JC, Samii K. Ventilatory response to carbon dioxide after intramuscular and epidural fentanyl. Anesth Analg. 1987;66(8):707–10.

    Article  CAS  PubMed  Google Scholar 

  77. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: An updated report by the American Society of Anesthesiologists task force on neuraxial opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2015, Dec 2011.

    Google Scholar 

  78. Hallworth SP, Fernando R, Bell R, Parry MG, Lim GH. Comparison of intrathecal and epidural diamorphine for elective caesarean section using a combined spinal-epidural technique. Br J Anaesth. 1999;82(2):228–32.

    Article  CAS  PubMed  Google Scholar 

  79. Giovannelli M, Bedforth N, Aitkenhead A. Survey of intrathecal opioid usage in the UK. Eur J Anaesthesiol. 2008;25(2):118–22.

    Article  CAS  PubMed  Google Scholar 

  80. Skilton RW, Kinsella SM, Smith A, Thomas TA. Dose response study of subarachnoid diamorphine for analgesia after elective caesarean section. Int J Obstet Anesth. 1999;8(4):231–5.

    Article  CAS  PubMed  Google Scholar 

  81. Kelly MC, Carabine UA, Mirakhur RK. Intrathecal diamorphine for analgesia after caesarean section. A dose finding study and assessment of side-effects. Anaesthesia. 1998;53(3):231–7.

    Article  CAS  PubMed  Google Scholar 

  82. Stacey R, Jones R, Kar G, Poon A. High-dose intrathecal diamorphine for analgesia after caesarean section. Anaesthesia. 2001;56(1):54–60.

    Article  CAS  PubMed  Google Scholar 

  83. Saravanan S, Robinson APC, Qayoum Dar A, Columb MO, Lyons GR. Minimum dose of intrathecal diamorphine required to prevent intraoperative supplementation of spinal anaesthesia for caesarean section. Br J Anaesth. 2003;91(3):368–72.

    Article  CAS  PubMed  Google Scholar 

  84. Cowan CM, Kendall JB, Barclay PM, Wilkes RG. Comparison of intrathecal fentanyl and diamorphine in addition to bupivacaine for caesarean section under spinal anaesthesia. Br J Anaesth. 2002;89(3):452–8.

    Article  CAS  PubMed  Google Scholar 

  85. Carvalho B, Drover DR, Ginosar Y, Cohen SE, Riley ET. Intrathecal fentanyl added to bupivacaine and morphine for cesarean delivery may induce a subtle acute opioid tolerance. Int J Obstet Anesth. 2012;21(1):29–34.

    Article  CAS  PubMed  Google Scholar 

  86. Cooper DW, Lindsay SL, Ryall DM, Kokri MS, Eldabe SS, Lear GA. Does intrathecal fentanyl produce acute cross-tolerance to i.V. Morphine? Br J Anaesth. 1997;78(3):311–3.

    Article  CAS  PubMed  Google Scholar 

  87. Lavand'homme PM, Roelants F, Waterloos H, Collet V, De Kock MF. An evaluation of the postoperative antihyperalgesic and analgesic effects of intrathecal clonidine administered during elective cesarean delivery. Anesth Analg. 2008;107(3):948–55.

    Article  PubMed  Google Scholar 

  88. Cossu AP, De Giudici LM, Piras D, Mura P, Scanu M, Cossu M, et al. A systematic review of the effects of adding neostigmine to local anesthetics for neuraxial administration in obstetric anesthesia and analgesia. Int J Obstet Anesth. 2015;24(3):237–46.

    Article  CAS  PubMed  Google Scholar 

  89. Alonso E, Gilsanz F, Gredilla E, Martínez B, Canser E, Alsina E. Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery. Int J Obstet Anesth. 2009, Apr;18(2):137–41.

    Article  CAS  PubMed  Google Scholar 

  90. Arkoosh VA, Palmer CM, Yun EM, Sharma SK, Bates JN, Wissler RN, et al. A randomized, double-masked, multicenter comparison of the safety of continuous intrathecal labor analgesia using a 28-gauge catheter versus continuous epidural labor analgesia. Anesthesiology. 2008;108(2):286–98.

    Article  CAS  PubMed  Google Scholar 

  91. Rigler ML, Drasner K, Krejcie TC, Yelich SJ, Scholnick FT, DeFontes J, Bohner D. Cauda equina syndrome after continuous spinal anesthesia. Anesth Analg. 1991;72(3):275–81.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Frimley Health NHS Foundation Trust, Surrey, UK

    Sarah Armstrong

Authors
  1. Sarah Armstrong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah Armstrong .

Editor information

Editors and Affiliations

  1. Dept of Anesthesiolgy, Città di Roma Hospital, Rome, Italy

    Giorgio Capogna

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Armstrong, S. (2017). Spinal Anesthesia for Cesarean Section. In: Capogna, G. (eds) Anesthesia for Cesarean Section. Springer, Cham. https://doi.org/10.1007/978-3-319-42053-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-42053-0_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42051-6

  • Online ISBN: 978-3-319-42053-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation