Percentage of cesarean delivery cases where general anesthesia was administered after neuraxial anesthesia.

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

Neuraxial Start to Anesthesia End 

Cesarean Delivery cases where neuraxial anesthesia was used.

• Cesarean Delivery cases determined by Obstetric Anesthesia Type value codes: 2, 6, 7.
• Neuraxial anesthesia determined by Anesthesia Technique Neuraxial value codes > 0.

• Cesarean delivery cases that use general anesthesia without neuraxial anesthesia.
• Cesarean Hysterectomies (determined by Obstetric Anesthesia Type value code: 4) 
• Non-cesarean delivery cases
• Placenta Accreta cases using the following ICD-10 codes:
  • O43.2, O43.21, O43.22, and O43.22
  • O43.[211, 212, 213, 219, 221, 222, 223, 229, 231, 232, 233, 239]

Cesarean delivery with neuraxial anesthesia completed without use of general anesthesia.

• The start time of neuraxial anesthesia is determined by the Obstetric Neuraxial Anesthesia Start Time phenotype. 
• Use of general anesthesia is determined by the Anesthesia Technique: General phenotype.
• Use of neuraxial anesthesia is determined by the Anesthesia Technique: Neuraxial phenotype.

*This measure will include valid MPOG cases defined by the Is Valid Case phenotype.

Not applicable.

Departmental only measure - not available for provider feedback emails.

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.