• W Dmyterko.
• Ginekol Pol. 1989 May 1;60(5):283-90.

AbstractThe use of subarachnoid anesthesia in Cesarean section in spite of its long history only now gains popularity. It is due to better knowledge of physiology and anatomy of a pregnant woman an the use of new local anesthetics and better needles for spinal anesthesia in clinical practice. Analgesia comprising segments Th4-S5 of the spinal cord provides painless operation and good muscle relaxation. In spinal anesthesia, unless there is arterial hypotension, intervillous flow increases. It is very important to prevent the syndrome of inferior caval vein by means of sloping the operating table by 15-20 degrees to the left, proper hydrating the patient, putting a wedge under the right hip, shifting the uterus to the left or putting the patient on right or left side. Analgesia consists in administering a local anesthetic into subarachnoid space. In this kind of analgesia the time elapse between the incision of skin and that of uterus muscle does not have a significant influence on the condition of newborns, which is contrary to general anesthesia. The time elapse between the incision of uterus muscle and extracting the fetus is a very significant factor both in spinal and general analgesia. The course of analgesia is very much influenced by preventing hypotension. It is done by fast infusion of 1500-2000 ml of electrolyte fluids within about 20 min., and the use of ephedrine. The prophylaxis of headaches consists in the use of very thin needles in spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

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