In recent years, many have raised concerns about the safety of epidurals and spinal anesthesia for woman in childbirth, but recent research may upend those opinions. A new study of New York hospitals finds that the rate of complications for women who received either epidurals or spinal anesthesia during cesarean delivery dropped by 25 percent over the past 10 years.
Cesareans Most Common Inpatient Procedure
More than 1.3 million C-sections are performed each year in the U.S., making cesarean deliveries the most common inpatient surgical procedure. Although women giving birth by C-section are at higher risk of developing complications from anesthesia than women who give birth vaginally, that risk has dropped significantly.
In cesarean delivery, epidurals or spinal anesthesia are commonly delivered to patients. Because c-sections involve incisions made through the abdomen and uterus to safely deliver babies, the procedure is extremely painful without anesthesia. Spinal and epidural anesthesia are the preferred methods in most cases, but occasionally general anesthesia is administered, particularly in emergency cesarean delivery.
The study, which was published in “Anesthesiology,” the official medical journal of the American Society of Anesthesiologists, evaluated 785,854 cesarean deliveries in New York state hospitals over about a decade. The study found that 5,715 of the deliveries had at least one anesthesia-related complication. However, complication rates dropped from 8.9 per 1,000 in 2003 to just 6.6 per 1,000 in 2012. The study found no decrease in complication rates for cesareans performed under general anesthesia over the same time period.
Complications in cesarean deliveries not related to anesthesia increased 47 percent over the last 10 years. The number of cesarean deliveries has also increased greatly in recent years. Today, cesarean deliveries account for around 35 percent of all deliveries, up from about 29 percent in 2003.
More women over the age of 40 and more women with pre-existing medical conditions are having cesarean deliveries today than in years past. Mortality rates after C-sections have decreased in that same time period, however, as care has improved over the past decade.
Kudos for Anesthesiologists
Anesthesia care is a continually evolving branch of medicine, with newer, safer anesthesia drugs and techniques constantly being introduced. The evolution of anesthesia practice has helped to make it safer for a wide variety of procedures, including C-sections.
An editorial written as a companion to the report praised anesthesiologists for their work in reducing complications related to anesthesia in cesarean deliveries. The editorial urged anesthesia doctors to take a more active role in helping reduce the non-anesthesia related complications, asking them to take the role of “peri-delivery” physicians.
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