
Pathway of the LSCS
-
Pre-assesment - routine anaesthetic and obstetric history, includes consent for regional anaesthesia
-
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
-
-
Position for regional anaesthesia (or supine with left lateral tilt for epidural top-up)
-
Ensure cannulated and cannula working
-
Monitoring to be placed whilst scrub up for spinal
-
Site spinal anaesthetic/top up epidural
-
Supine with left lateral tilt
-
Maintain MAP throughout as appropriate, increased frequency measurement (1-2min)
-
Check regional block height
-
Give antibiotics
-
Once baby delivered give appropriate uterotonic (eg oxytocin/carbotocin )
-
Remove left lateral tilt, reduced frequency of BP measurement to 5mins
-
Ensure post-operative analgesia/antiemetics prescribed
-
Discuss post-operative VTE prophylaxis with obstetric team and prescribe
-
Transfer to recovery, handover and ensure follow-up paperwork is complete