Anaesthetic procedure for elective caesarean section (C section)

the elective cesarean section is one

that's planned in advance the decision

to have a cesarean section is made

between patient and the obstetricians

once we are given a list of ladies who

are going to have elective cesarean

sections we then are inviting them to

come and see us in the anesthetic clinic

within a week of the date of their

cesarean section we will give you two

types of tablets once an anti acid

tablet wants an anti sickness tablet and

will ask you to take one the night

before your coming in for your cesarean

and both tablets in the morning off your

cesarean section that just reduces the

risk of you feeling sick during the

operation and makes it less likely that

we have problems with with you having

acid in your tummy our standards

anesthetic for an elective cesarean

section is what we call a combined

spinal and epidural anesthetic and that

is both the spinal anesthetic and an

epidural when you come in you'll be

directed to one of rooms our assessment

rooms on delivery suite and then you

will be visited by variety of people

this will include the aneesa's that

we'll be looking after you on the day

the surgeons the obstetricians will come

and see you and go through their consent

form for the operation with you and the

midwives will come in and have a listen

to your baby and some of the theater

staff will come and make sure that you

have the gown and that you're all ready

to go the first thing that we always

have to do before an anaesthetic is put

in a drip or a cannula into one of the

veins usually in the hand or the arm

this is a safety thing so if there's any

problems from the anaesthetic that we

can give fluids and drugs and medicines

down into that drip quickly any statists

will dress up almost like the surgeons

do for the operation and they clean the

back with something that's really quite

cold makes people jump and that's just

to reduce the risk of introducing any

infection into the injection site in the

back to do the spinal aperture all

injections we have to get the ladies

usually to sit on the edge of the bed

and they have to bend forward slightly

and curl up we say a bit like an angry

cat or if you're carrying heavy shopping

and what this does it

opens up the spaces between the bones in

the back and we put some a local

anesthetic into the skin of the back now

that does sting a little bit when it

first goes in and we then put some

further into the back but then makes the

area nice and numb for having the

injection done afterwards I remember

some really cold solution going on my

back and I said that was just to clean

the area and then that I think the sting

EBIT made being a local anesthetic just

to numb that area when the injections

being done it shouldn't be painful and

you should be able to feel a pushing or

maybe a slight aching feeling in the

back and if you feel any other pains you

should tell the any statistics doing

your anaesthetic see a spinal anesthetic

is just an injection which is then

removed the epidural is a really fine

small tube which is then left in the

back there's nothing sharp left in it's

just a small plastic tube we then want

to see injections in we get the ladies

to lie down quite quickly that's because

the local anesthetic works with gravity

the ladies start to feel some warm Ness

in the bottom and tingling pins and

needles in the legs and then their legs

feel really heavy and difficult to move

around while the numbness is coming on

which usually takes up to about ten

minutes we also have to put a catheter

which is a small tube into the lady's

bladder because the bladder is very

close to where the operation is taking

place and we want to empty and out of

the way there's always a small risk that

the anesthetic won't make you numb

enough for the surgeons to start the

operation the tech checks their block

very thoroughly and we do this using a

freezing cold spray doing Lisa - she

tested the anesthetic with some cold

spray she said it was she tested it

first up here on my my collarbone and it

was really cold and then she said she

was spraying and up both sides of my

legs and up went on my tummy and I

couldn't feel any of that at all

I was quite quite strange but reassuring

if for some reason that numbness isn't

good enough we then have some other

options to go through which might

involve another injection or an epidural

and we always have the backup option of

a general anaesthetic

we really need to when the injections

done and the numbness is coming on from

both an epidural and a spinal anesthetic

it is normal for your blood pressure to

drop we keep a really close eye on the

blood pressure in theatres and you have

a blood pressure cuff that will inflate

and deflate on your arm every minute but

sometimes people's blood pressure drops

quicker than other times and if you feel

dizzy or sick at any point it's probably

because of your blood pressure we have

lots of medicines that we can give into

the drip to help the blood pressure back

up I might drop my blood pressure but

there was some medication that they

could give to increase my blood pressure

might feel a bit dizzy but long-term

very very rare that anything long-term

would come of it and with regard to

meeting my legs it or anything like that

other risks are very generally very rare

and that's why we choose and this kind

of anaesthetic as our first choice and

they include things like a severe

headache and a very small risk of damage

to the nerves themselves it's most

likely to be a patch of numbness on

their leg somewhere that would go in its

own over a few weeks to months that

happens to about 1 in 10 to 15,000

people the risk of it being a most

severe permanent weakness and numbness

of the legs is incredibly rare in the

region of one in a hundred thousand once

we're happy that the anesthetic is

working and that the catheters in and we

then get the birthing partners to come

in they have to wear a hat in the gown

and they come and sit up at the head end

with you and with you a nice artist my

partner he was brought in and he came in

sat next to me he's allowed to bring his

camera in to take pictures for the baby

when the baby was born and it was just

lovely because he could sit there and

hold my hand

they put a drape up so I couldn't see

anything really over the top is like a

little tent and that was across my

partner as well so he couldn't see over

because I just remember feeling really


I didn't feel scared I just was really

happy that I was gonna see my baby soon

it's normal to feel pressure pearling

pushing that kind of thing some people

describe it like a rummaging type

sensation your needs to still be with

you to assure you if you need them to

any point during the operation it's much

more common to feel that rummaging

sensation before the baby's born which

is usually within the first five or ten

minutes of the operation I remember them

saying there might be some tugging might

feel some rummaging in my tummy and they

were reassuring me all the time I was to

feel sick at any point or anything felt

strange just to talk just to let them

know so I felt reassured the concern was

always somebody there with me so when

the baby's born it may go over to

resuscitate which is an area where

there's heating and light for the

midwives and sometimes the baby doctors

to look at the baby to make sure that

they're okay then once they're happy

that the baby is is okay and safe

they'll bring the baby over to have

cuddles and skin-to-skin with mum it's a

bit awkward because you will be lying

flat on your back and it's very

difficult to do any kind of feeding

during theatre because of that reason

but cuddles are are finan and your

partner can help you and support your

baby and cuddle them so baby was born

and they took him away over to the side

and they did their checks on the to make

sure he was breathing as

okay there rub baby down wrap him up in

the towel and let me cuddle him first

before they waiting so it wasn't wasn't

much of a delay between baby being born

and having his checks and then BOOM

brought to me once the baby's born the

operation takes a bit longer but there's

much less of the rummaging sensations

there depending on your medical history

and and allergies of course we will

sometimes advise that you have a pain

killing tablet put into your bottom at

the end of the operation and that works

really well as the numbness starts to

wear off the you're then written up some

regular tablets of painkillers and some

other tablets and syrup that you can ask

for if you need them afterwards after a

cesarean section the epidural is left in

usually for around six to eight hours

after the eighth caesarean you go

through to our observation area which is

award just next to delivery suite where

we keep an eye on all the ladies who

have recently had operations and the

reason for leaving the epidural in is we

can give further pain relief down the

epidural and that can be done on this

ward once you are recoverers enough than

the epidural is removed having Epogen

removed is it's very straightforward and

a painless procedure usually within

three or four hours of you leaving the

operating theater and your legs will

start to be able to use them again and

start to gently walk around there's

about an hour to two hours afterwards

and it was a it was slowly the feeling

in my legs that's what I remember coming

back there's like tingling feeling again

like when they put the injection in the

first time and then slowly with time

there's a bit more discomfort him in the

tummy area where they done the sits

there in section and he could feel the

tingling in the legs and then I could

start wiggling my toes and do a bit more

their first 24 hours particularly after

cesarean section

it can be quite uncomfortable most women

cope really well on the the tablets that

we give them for pain relief but it's

important that once your numbness has

worn off that you're able to get up up

and out of bed just gently and go to the

toilet and that kind of thing and if you

feel that you're unable to get out of

bed because it's too painful then you

must ask for further pain relief from

the midwives the pain relief that was

given was some morphine and paracetamol

and a drug they say was called [ __ ]

inequities I think like ibuprofen urine

there was the morphine that was the they

gave that to me to drink and that was

the medication that definitely helped

with the pain by the next morning I

wasn't really needing any morphine or

anything like that I was just having the

regular paracetamol and dicker phonetic

I was taking that regularly and when I

came home I was probably still taking

those another few days and then I would

stop taking the dicker Finnick and then

the paracetamol so within a week I would

have thought that if I had to take the

painkillers for really the main

discomfort was getting up out of bed to

go and pick up the baby that that was a

bit that was that was the hardest part

and that was the most uncomfortable part

getting around walking around there

wasn't any discomfort

I had no infections afterwards the

wounds clean here what really nicely

the scars looking better every day and

had no after-effects at all most ladies

he has his errands here have a very

positive experience

we are very friendly we will make you

very welcome answer any questions more

than happy to answer any questions that

you have and look after you so you can

meet your baby