Pathway of the LSCS

1. Pre-assesment - routine anaesthetic and obstetric history, includes consent for regional anaesthesia

2. Theatre preparation as necessary:

   • check emergency drugs and appropriate uterotonic

   • if for epidural top up, prepare local anaesthetic and opiate as per trust policy or personal preference

   • discussion with ODP

   • checking of anaesthetic machine 

3. Position for regional anaesthesia​ (or supine with left lateral tilt for epidural top-up)

4. Ensure cannulated and cannula working

5. Monitoring to be placed whilst scrub up for spinal

6. Site spinal anaesthetic/top up epidural

7. Supine with left lateral tilt

8. Maintain MAP throughout as appropriate, increased frequency measurement (1-2min)

9. Check regional block height

10. Give antibiotics

11. Once baby delivered give appropriate uterotonic (eg oxytocin/carbotocin      ) 

12. Remove left lateral tilt, reduced frequency of BP measurement to 5mins

13. Ensure post-operative analgesia/antiemetics prescribed

14. Discuss post-operative VTE prophylaxis with obstetric team and prescribe

15. Transfer to recovery, handover and ensure follow-up paperwork is complete

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