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The Vanashing GA section

Monday, 24 June, 2013 - 12:54
Board 01

The vanishing GA-section



Over the last 20 years, obstetric anaesthesia has become dominated by regional techniques, with general anaesthesia (GA) being reserved only for specific cases. This is largely to be welcomed as GA carries higher risks, but it has had a detrimental impact on training. Considering the fact that most GA caesarean sections are performed as an emergency and out of hours, immense pressure is placed on anaesthetic trainees who often have limited experience.     



To determine the number of GA caesarean sections performed atRoyalOldhamHospitalin 1991, 1995 and 2011.



The maternity database atRoyalOldhamHospitalwas searched to obtain information regarding the total number of deliveries, caesarean sections and mode of anaesthesia used. 



The number of women delivering by caesarean section has dramatically risen from 5.2% in 1991 to 24.7%.

GA was used in 55.7% of caesarean sections performed in 1991, in contrast to only 12.4% in 2011. 78.0% of GA sections in 2011 were emergencies, compared to only 27.3% in 1995 where more than two thirds were performed as elective.



Obstetric trainees should be aware of the limited opportunities available to anaesthetic trainees to gain experience in GA caesarean section. Timely decision of emergency caesarean sections, particularly out of hours, and good team communication are essential.