P084: THE IMPORTANCE OF ANESTHETIC EDUCATION AND MANAGEMENT IN A COMPLICATED C-SECTION: A CASE REPORT
A K Arroyo Rodriguez1; G Jordan1; P Chindavong1; M Ibrahim1; D Khadka1; P Patel1; J Cherlois, MD2
1Alabama College of Osteopathic Medicine; 2North Baldwin Infirmary
Introduction/Background: Inadequate anesthesia management during cesarean delivery, particularly among racial and ethnic minority women, has been linked to increased maternal morbidity and mortality. Studies have shown that Black and Hispanic women are more likely to receive general anesthesia for cesarean deliveries compared to White women. This disparity is associated with a higher risk of complications such as pulmonary aspiration, wound infection, and prolonged recovery.
Several factors contribute to these disparities, including implicit bias, patient-provider communication, and systemic barriers. Implicit bias, or unconscious stereotypes and prejudices, can influence decision-making and lead to disparities in care. Effective communication between patients and providers is essential for understanding and addressing individual needs and preferences. Systemic barriers, such as limited access to specialized care and inadequate insurance coverage, can also hinder optimal anesthesia care.
Methods: A case report was conducted to describe a complex surgical scenario involving a 32-year-old multiparous woman who presented for a repeat cesarean delivery.
Results: Despite a planned epidural anesthetic, the patient experienced significant intraoperative pain and movement, necessitating deep sedation to manage her discomfort. This unexpected response to anesthesia posed challenges to the surgical team and prolonged the procedure. The patient's history of multiple previous cesarean deliveries resulted in extensive intra-abdominal adhesions, further complicating the surgical course.
Discussion/Conclusion: This case underscores the importance of comprehensive preoperative patient assessment and counseling, including a detailed review of medical and surgical history, substance use, and pain management preferences. A thorough understanding of the patient's individual needs can help optimize anesthesia management and minimize intraoperative complications.
Furthermore, this case highlights the need for ongoing research to identify factors that contribute to inadequate anesthesia response and to develop strategies to improve patient outcomes. By addressing these challenges, healthcare providers can work to ensure safe and effective anesthesia care for all women undergoing cesarean delivery.