A few days ago, a patient asked me: They are all operations related to pregnancy, why use general anesthesia for abortion and half anesthesia for cesarean section? Is cesarean section not as important as abortion? Caesarean section requires a large incision in the stomach, so it is reasonable to use general anesthesia, and abortion operations are all under general anesthesia, why does cesarean section require half anesthesia?
To understand this question, let’s first understand what is general anesthesia? What is half hemp?
General anesthesia is generally divided into three methods: endotracheal intubation, intravenous injection and inhalation. General anesthesia is a kind of anesthesia that makes the patient lose consciousness, has no pain, and temporarily and reversibly disappears memory. This method is suitable for most surgeries.
Semi anesthesia is a partial anesthesia, the most commonly used is spinal anesthesia, which is generally suitable for most lower extremity and lower abdominal operations, such as cesarean section.
Why is abortion surgery “general anesthesia”?
Induced abortion is to peel off the embryo that has not yet fully developed in the female body, which is very painful, and may have reactions such as nausea and vomiting, which will bring great harm to the operation. obstacles. After anesthesia, the anesthetic suppresses the human consciousness and muscles, etc.
More importantly, general anesthesia is also divided into sizes. Abortion surgery is intravenous general anesthesia with short time and less medication, which is also known as “painless abortion”.
The patient quickly falls into a short period of deep sleep, during which the doctor can perform the operation without interruption, as if the patient had fallen asleep and woke up to the surgery ended. It is obviously not suitable to do a large anesthesia for such a small operation.
Why is “half anesthesia” more common for cesarean section?
Cesarean section is the removal of a 10-month-old baby, and the procedure must go smoothly. This operation requires a lot of anesthesia.
However, heavy use of narcotics is likely to numb the baby as well. Not only the effect of anesthesia is good, but also the use of less medication, spinal anesthesia reflects its advantages. The local anesthetic is injected into the epidural space or subarachnoid space through puncture to block the spinal nerve root to achieve anesthesia effect.
During anesthesia, a puncture is made in the lumbar space of the pregnant mother, and the anesthetic is slowly injected through a tube. When the anesthesia took effect, the mother’s abdomen and lower limbs gradually lost sensation, but her brain and upper body were awake, and she could get close to her baby as soon as possible after the operation.
If general anesthesia is selected for cesarean section, general anesthesia drugs are mostly injected intravenously. Drugs are likely to pass through the placenta and affect the baby’s score after birth and the ability to adapt to the outside world.
In addition, due to the physical changes of pregnancy, mothers are at increased risk of having a difficult airway. Some mothers did not strictly fast food and drink before surgery. Food may flow back during general anesthesia. Once the vomit enters the trachea and lungs, it is a terrible thing.
But it does not mean that general anesthesia cannot be selected for cesarean section, and general anesthesia will still be selected in special circumstances. For example, there is a contraindication to semi-anesthesia; the maternal hemorrhage during labor is in critical condition; the maternal psychological capacity is too poor, or cannot cooperate with semi-anesthesia; semi-anesthesia fails; at this time, general anesthesia needs to be changed.
In general, cesarean section and abortion, whether general anesthesia or semi-anesthesia are selected, are for safety and health considerations. For this issue, pregnant mothers should follow the advice of the anesthesiologist. . After all, being able to soberly perceive the birth of a baby and listen to the baby’s first cry after coming to the world is the only kind of rare happiness.
Author: Zhang Hailing, Director of Anesthesiology Department of Weihui Maternal and Child Health Hospital
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