Let's talk briefly about general Anaesthesia for caesarean section . One to 1.5 mg per kg of succinylcholine is still the best muscle relaxant for intubation. Rocuronium is next alternative. Preoxygenation is a must. The usual dose of propofol used for induction rarely produce any effects in the new born. Maintenance is usually achieved using propofol, volatile anaesthetic, oxygen and muscle relaxant.
Opioid is usually delayed till the delivery of the child. Benzodiazepine like midazolam can easily cross the placenta and can produce hypotonia of the child. Use of volatile anaesthetic is a must to avoid awareness during the surgery. Better to give it around 0.75 MAC. Excessive volatile anaesthetic can cause respiratory depression and flaccidity in the new born as it rapidly crosses the placenta. Ketamine induction is advised for hemorrhaging pregnant lady.
