Chapter 8: Anaesthesia

Anaesthesia: Specific recommendations

All patients, including women in early pregnancy whose treatment is generally managed by gynaecological services, require the same high standard of anaesthetic care. This includes early recovery from anaesthesia for which anaesthetic services have full responsibility. Recovery staff must be able to receive immediate effective assistance from an anaesthetist until the woman is fully conscious and has stable vital signs.

Trainee anaesthetists must be able to obtain prompt advice and help from a designated consultant anaesthetist at all times. They and their consultants must know the limits of their competence and when close supervision and help are needed. Morbidly obese women should not be anaesthetised by trainees without direct supervision.

Trainees across all specialties may not have the experience or skill to recognise a seriously ill woman. Referral to a consultant or senior trainee should occur if there is any doubt about a woman’s condition. Early warning scores may help identify the mother who is seriously ill. Bedside estimation of haemoglobin concentration is valuable. Many of these points are reiterated in the “top-ten” Recommendations of this Report.