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