Gas Cookbook | LSCS (Under General Anaesthesia)

LSCS (Under General Anaesthesia)

General AnaesthesiaDuration1 hourUpdatedJun 2026

3-way octopus to cannula (Fluid + Phenylephrine infusion + Spare port)
Pre-oxygenation during catheterisation + surgical preparation
DAS Obstetric Guidelines
Antibiotics as per trust polict

RSI
Videolaryngoscopy
Optimise position - Oxford / HELP pillow + Left lateral tilt
Propofol200-250mg
Rocuronium1.2mg/kg
AirwayETT

Maintenance

SevofluraneMAC 1.2 or Propofoltitrate to BIS

Infusions

phenylephrineTitrate to effect

Antibiotics

Cefuroxime1.5g
Metronidazole500mg

Uterotonics (Check contraindications)

Carbetocin100mcg or Oxytocin

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

ProcedureNMB Assessment
Sugammadex
Awake extubation

Analgesia

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

Anti-emetic

Ondansetron4mg

Other

Laxative
LMWH 6 hours post-op
TEDS
Fluids

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.

Technique

IV Induction RSI TIVA Volatile

By Jeremy Chui

Pre-op

Induction

Intra-op

Additional (If Required)

Emergence

Post-op

LSCS Key Stages

Additional Resources