The National Institute of Clinical Excellence (NICE) guidelines for caesarean sections: implications for the anaesthetist.

INTRODUCTION The bodies involved; Background; Aims of the guidelines; Evidence and grading of recommendations SUMMARY OF RECOMMENDATIONS AFFECTING ANAESTHETIC PRACTICE Provision of information and consent Classification of urgency of caesarean section Planned caesarean section Factors in intrapartum care affecting likelihood of caesarean section Factors with no influence on caesarean section rates: Epidural analgesia; Eating in labour Procedural aspects of caesarean section: Decision-to-delivery interval for emergency caesarean section; Preoperative testing and preparation for caesarean section; Urinary catheterisation at caesarean section Aspects of anaesthesia for caesarean section: Antacids and antiemetics; General versus regional anaesthesia for caesarean section; Converting epidural analgesia to anaesthesia for caesarean section; Place of induction and monitoring during caesarean section; Procedures to avoid hypotension; Failed intubation Surgical techniques for caesarean section of relevance to the anaesthetist: Use of uterotonics; Uterine exteriorisation; Use of antibiotics; Thromboprophylaxis for caesarean section Care of the baby born by caesarean section Care of the woman after caesarean section: High dependency and intensive care admission; Routine monitoring after caesarean section Pain management after caesarean section: Intrathecal and epidural analgesia; Patient controlled analgesia (PCA) and non-steroidal anti-inflammatory analgesics; Other local anaesthetic techniques Post partum care: Early eating and drinking after caesarean section; Urinary catheter removal after caesarean section; Length of hospital stay CONCLUSION