Anesthesia for Cesarean Delivery—Regional or General?

The 2018 cesarean delivery rate in the United States was 31.9%, down slightly from its peak in 2009 of 32.9%. 1 The cesarean delivery rate is likely to increase further because women are requesting an elective cesarean delivery even for their first delivery and because the number of women attempting a vaginal birth after a prior cesarean is decreasing. The selection of regional or general anesthesia for cesarean delivery depends on the experience of the anesthesiologist, past medical history of the patient, maternal airway examination, and the indication for and urgency of the cesarean delivery. In this review the anesthetic considerations will be discussed for both the elective case, where there is little controversy that regional anesthesia is the preferred technique, and the emergent case, where controversy exists.