Choosing the Right Anesthesia Method for Laboring Clients with Thrombocytopenia

What is the recommended method of anesthesia for a laboring client with thrombocytopenia requiring a cesarean delivery?

1. General anesthesia
2. Epidural anesthesia
3. Spinal anesthesia
4. Regional anesthesia

Answer:

For a laboring client with thrombocytopenia needing a cesarean delivery, regional anesthesia is often preferred. However, if the client's condition warrants, general anesthesia may be chosen. The final decision should be made after a thorough review by the surgical and anesthetic team.

When caring for a laboring client with thrombocytopenia who requires a cesarean delivery, the choice of anesthesia is critical due to the increased risk of bleeding. Regional anesthesia, which includes epidural and spinal anesthesia, is often preferred to general anesthesia because it allows for pain control without the systemic effects that might exacerbate bleeding disorders. However, if platelet counts are very low, or if there are other complications, the anesthesiologist may opt for general anesthesia to avoid the risk of spinal or epidural hematoma that can result from regional techniques. The decision should be made after a multidisciplinary discussion among the surgical team, which includes the surgeon, nurse, and anesthesia professional. These team members will orally confirm and review the key concerns for the recovery and care of the patient, taking into account all factors that may influence the choice of anesthesia method.