Local Anaesthetic Infiltration for Caesarean Section

Abstract

Current high standards of obstetric anaesthesia, with an increasing trend to caesarean section being performed under epidural blockade, preclude this procedure being done under local anaesthetic infiltration in developed countries. Two cases are presented, one being elective and the other an emergency case where local anaesthetic infiltration was used. Case 1 A 22-year-old woman with severe congenital kyphoscoliosis, pelvic tilt and dislocated right hip, presented for elective caesarean section at 38 weeks due to cephalopelvic disproportion. She had been paraplegic since birth with only partial sensory loss. There was some sensation between TI0 and Ll. Previous obstetric history consisted of two previous pregnancies, one terminated at eight weeks, and the other miscarried at three weeks. General anaesthesia had been administered in childhood for lower limb orthopaedic procedures. Concern was now raised due to impairment of diaphragmatic excursion from pregnancy compounded by compromised respiratory •F.