General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey

We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted from clinical notes. There were 14244 deliveries during the study period with a cesarean section rate of 25.2% (3583 cases). Of these, 20.4% (732 cases) were performed under general anesthesia. Maternal request was the chief reason for general anesthesia, especially among elective cases. Regional block failure accounted for 16% of the general anesthesia cases performed or 4.0% of the total regional techniques attempted. Regional block failure rate was highest for emergency cases in which an indwelling labor epidural catheter was used to provide surgical anesthesia via a bolus top-up. General anesthesia still has a definite place for cesarean delivery despite the predominant use of regional techniques in our institution.