General anaesthetic

These are some of the reasons why you may need a general anaesthetic rather than a spinal or epidural:

• If you need a caesarean very urgently, there may not be enough time for a spinal or epidural anaesthetic to work
• If you have certain medical conditions such as a bleeding tendency or abnormalities of your back
• Occasionally, a spinal or epidural anaesthetic may be unsuccessful or inadequate for surgery

In most situations, your birth partner will not be able to come into the operating theatre if you have a general anaesthetic as the team need to focus their attention on you and your baby.  However, your birth partner will be nearby and will be kept updated and be able to see you after the operation.

The anaesthetist’s assistant will attach equipment to measure your blood pressure, heart rate, and the amount of oxygen in your blood. You may be asked to drink an antacid medicine to reduce the acid in your stomach. You will be given oxygen to breathe through a facemask for a few minutes.  The obstetrician may clean your tummy and insert a catheter (plastic tube) into your bladder so that they are ready to deliver your baby once you are safely asleep. Once the team are ready, the anaesthetist will give the anaesthetic into your drip. As you go off to sleep, the anaesthetic assistant may apply some pressure to your neck. This is to prevent any stomach fluid getting into your lungs.
 
When you are unconscious, the anaesthetist will place a breathing tube into your throat. The anaesthetist will keep you asleep and monitor you closely while the obstetrician delivers your baby. Your baby will be cared for by the specialist baby nurse or doctor initially.  If your baby does not need any specialist care, the midwife will then look after your baby until you are out of theatre. After your baby is delivered, the obstetrician will close your tummy. Some local anaesthetic will be given into your tummy at the end and you may be given a suppository (tablet) into your bottom to help relieve pain when you wake up.

Once the surgery is complete (approximately 45-60 minutes), the anaesthetic medicine that is keeping you asleep will be stopped, you will gradually wake up and the breathing tube will be removed. You will then be transferred from theatre into another area to recover. You may feel sleepy for a while until the anaesthetic wears off. Some discomfort from the operation is expected and you may feel sick. You will receive more medicine to help with pain or sickness if needed.  

Your birth partner and baby will usually be able to join you in the recovery area. If your baby needed assistance at delivery, they might be receiving further care on the neonatal unit. You will be able to visit them on the neonatal unit as soon as you feel well enough.

There are some potential complications or events that are related to the anaesthetic itself. Some of these occur quite commonly, but are generally minor or short lived. Serious complications are uncommon or rare.

Common problems: feeling sick and vomiting, a sore throat, shivering or itching.

Uncommon complications: breathing difficulties after the anaesthetic, damage to lips or teeth, and accidental awareness during anaesthesia. Accidental awareness is when a patient may have memories of events in the operating theatre. The majority of patients who become accidentally aware do not feel pain. If you would like information about this, please speak to your anaesthetist or read this pdf. 

Rare complications: severe allergic reaction, most commonly to medicines.

Very rare complications: brain damage or death caused directly by anaesthesia is extremely rare.