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Cited by 137Anesthesia and Pain ManagementMaternal and Perinatal Health InterventionsAnesthesia and Sedative Agents

The Current Role of General Anesthesia for Cesarean Delivery

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Ring, Laurence, Landau, Ruth, Delgado, Carlos·2021·Current Anesthesiology Reports
DOI 10.1007/s40140-021-00437-6PMC PMC7902754
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Abstract

Purpose of the review The use of general anesthesia for cesarean delivery has declined in the last decades due to the widespread utilization of neuraxial techniques and the understanding that neuraxial anesthesia can be provided even in urgent circumstances. In fact, the role of general anesthesia for cesarean delivery has been revisited, because despite recent devices facilitating endotracheal intubation and clinical algorithms, guiding anesthesiologists facing challenging scenarios, risks, and complications of general anesthesia at the time of delivery for both mother and neonate(s) remain significant. In this review, we will discuss clinical scenarios and risk factors associated with general anesthesia for cesarean delivery and address reasons why anesthesiologists should apply strategies to minimize its use. Recent findings Unnecessary general anesthesia for cesarean delivery is associated with maternal complications, including serious anesthesia-related complications, surgical site infection, and venous thromboembolic events. Racial and socioeconomic disparities and low-resource settings are major contributing factors in the use of general anesthesia for cesarean delivery, with both maternal and perinatal mortality increasing when general anesthesia is provided. In addition, more significant maternal pain and higher rates of postpartum depression requiring hospitalization are associated with general anesthesia for cesarean delivery. Summary Rates of general anesthesia for cesarean delivery have overall decreased, and while general anesthesia no longer is a contributing factor to anesthesia-related maternal deaths, further opportunities to reduce its use should be emphasized. Raising awareness in identifying situations and patients at risk to help avoid unnecessary general anesthesia remains crucial.

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  • General anesthesia induces unconsciousness and is now reserved primarily for emergent/STAT cesarean deliveries when neuraxial anesthesia is contraindicated, unavailable, or when there is not enough time for neuraxial anesthesia to provide an adequate block.

    “General anesthesia induces unconsciousness and is now reserved primarily for emergent/STAT cesarean deliveries when neuraxial anesthesia is contraindicated, unavailable or when there is not enough time for neuraxial anesthesia to provide an adequate block.33,34”

    From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [34]

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Cited by

Sorted by citations

Authors
Ring, L., Landau, R., & Delgado, C.
Affiliations
  • Columbia University Irving Medical Center (US)
  • University of Washington (US)
Corresponding author
Landau, Ruth
ORCID
Venue
Current Anesthesiology Reports
Publisher
Springer Science and Business Media LLC
Published
2021-02-24
Volume
11
Issue
1
Pages
18-27
ISSN
  • 1523-3855 (ISSN-L)
  • 2167-6275
DOI
10.1007/s40140-021-00437-6
PMC
PMC7902754
OpenAlex
W3132750507
Cited by
137
References
1
Citations by year
2026: 20 · 2025: 37 · 2024: 35 · 2023: 25 · 2022: 14 · 2021: 5
FWCI
4.81
Type
journal article
Language
en
Open access
Licence
Locations
  • Current anesthesiology reports (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
Keywords
general anesthesia, cesarean section, neuraxial anesthesia, surgical site infection, venous thromboembolism, racial and socioeconomic disparities, resource-limited settings, maternal mortality, perinatal mortality, postpartum pain, postpartum depression, endotracheal intubation, maternal risk factors

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