Measure ID
GA 01-OB
Domain
Obstetrics
Description

Percentage of cesarean delivery cases where general anesthesia was used

Measure Type
Outcome
Rationale

General anesthesia is used in roughly 5% of elective cesarean deliveries and 14-20% of emergent cesarean deliveries.1,2 Mothers who receive neuraxial anesthesia report less pain on the day of surgery, show less gastrointestinal stasis, fevers, and coughing on post op day 2, and show earlier mobility and breastfeeding onset than those who receive general anesthesia.3  Mothers who receive general anesthesia during cesarean delivery may also be at increased risk of severe postpartum depression as compared to those who receive neuraxial anesthesia.4

Threshold
N/A - Informational only
Measure Time Period

Anesthesia Start to Anesthesia End 

Inclusions
  • Cesarean Delivery cases as determined by the “Obstetric Anesthesia Type” Phenotype. Phenotype results included:
    • Cesarean Delivery
    • Conversion (Cesarean Delivery Portion)
    • Conversion (Labor epidural and cesarean delivery combined)
Exclusions
Success Criteria

Cesarean delivery completed without use of general anesthesia

Other Measure Details

Measure Start Time: Anesthesia Start

Measure End Time: Anesthesia End

  • Use of general anesthesia is determined by the ‘Anesthesia Technique: General’ phenotype
  • Cases where ‘measure end’ precedes ‘measure start’ will be excluded from the measure
Risk Adjustment

N/A

Provider Attribution

N/A - Departmental only 

MPOG Concept Used

See concepts included in the ‘Obstetric Anesthesia Type’ phenotype and ‘Anesthesia Technique: General’ phenotypes

References
  1. Traynor, Andrea J., Meredith Aragon, Debashis Ghosh, Ray S. Choi, Colleen Dingmann, Zung Vu Tran, and Brenda A. Bucklin. 2016. “Obstetric Anesthesia Workforce Survey: A 30-Year Update.” Anesthesia and Analgesia 122 (6): 1939–46.
  2. Juang, Jeremy, Rodney A. Gabriel, Richard P. Dutton, Arvind Palanisamy, and Richard D. Urman. 2017. “Choice of Anesthesia for Cesarean Delivery: An Analysis of the National Anesthesia Clinical Outcomes Registry.” Anesthesia and Analgesia 124 (6): 1914–17.
  3. Morgan, B. M., J. M. Aulakh, J. P. Barker, P. W. Reginald, T. Goroszeniuk, and A. Trojanowski. 1984. “Anaesthetic Morbidity Following Caesarean Section under Epidural or General Anaesthesia.” The Lancet 1 (8372): 328–30.
  4. Guglielminotti, Jean, and Guohua Li. 2020. “Exposure to General Anesthesia for Cesarean Delivery and Odds of Severe Postpartum Depression Requiring Hospitalization.” Anesthesia and Analgesia 131 (5): 1421–29.
Measure Reviewer(s)
Next Review: 2024
 Date Reviewed  Reviewer  Institution  Summary  QC Vote

NA

NA

NA

NA

NA

Version
Published Date: 02/2021
 Date  Criteria  Revision
 06/09/2021   Exclusion   Added check for Conversion (Cesarean Hysterectomy portion) as determined by the obstetric anesthesia type phenotype