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This collection of recipes is intended for educational purposes only. Users should adapt these recipes based on individual patient requirements, clinical judgment, and adherence to local and national guidelines.

We cannot be held liable for any adverse outcomes or issues arising from the use or application of these recipes.

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Gas Cookbook | Elective LSCS (Single Shot Spinal)

Elective LSCS (Single Shot Spinal)

Pre-op Block Intra-op Additional (If Required)Post-op LSCS Key Stages Additional Resources

Obstetrics

Elective LSCS (Single Shot Spinal)

Regional AnaesthesiaDuration1 hourUpdatedJun 2026

Pre-op Block Intra-op Additional (If Required)Post-op LSCS Key Stages Additional Resources

One / both arms out of gown (enables better skin to skin later)
3-way octopus to cannula (Fluid + Phenylephrine infusion + Spare port)

either

NeuraxialSpinal

0.5% bupivacaine + 8% glucose2.2-2.6 ml

fentanyl15-20 mcg

morphine0.1 mg

NeuraxialSpinal

0.5% bupivacaine + 8% glucose2.2-2.6 ml

Monitoring

NIBP 1-2 min cycles initially
ECG
Pulse oximetry

Infusions

phenylephrineTitrate to effect

Antibiotics

Cefuroxime1.5g
Metronidazole500mg

Uterotonics (Check contraindications)

Carbetocin100mcg or Oxytocin5 IU
Once baby delivered + cord clamped

Analgesia

Anti-emetics

ondansetron4mg

Uterotonics

ergometrine500mcg, IM : Avoid in pre-eclampsia / hypertension
carboprost / Hemabate250mcg, IM : Avoid in asthma. Every 15 minutes up to 8 doses.
misoprostol4 x 200mcg, PR

Other

Tranexamic acid1g

Analgesia

Paracetamol1g, QDS
Ibuprofen400mg, TDS
Dihydrocodeine30mg, QDS
Dihydrocodeine30mg, QDS PRN
MorphinePO, PRN

Anti-emetic

Ondansetron4mg

Other

Laxative
LMWH 6 hours post-op
TEDS
Fluids

Follow-Up

Pfannenstiel / Joel-Cohen incision (transverse lower abdomen)
Dissection through skin, fascia, rectus sheath, rectus muscle, peritoneum -> to reveal uterus
Bladder retraction
Uterine incision
Fundal pressure from assistant
Delivery (+/- delayed cord clamping)
Placental delivery (controlled cord traction)
Closure of uterine cavity (2 layers), rectus sheath, skin

Labour Pains

For reference only. Always check doses against the BNF and your local protocols, and adapt to the patient in front of you. Gas Cookbook is community-shared guidance, not medical advice; clinical responsibility stays with you.

Procedure

Spinal

By Jeremy Chui

diamorphine

300 mcg

Start phenylephrine100mcg/ml, 20ml/hr once spinal is administered

2 ml bolus to clear deadspace
Target normotension

Diclofenac

100mg, PR

Paracetamol1g

Check for block recovery (Able to raise legs 4 hours post block)