Supplementary oxygen for elective Caesarean section under spinal anaesthesia: useful in prolonged uterine incision-to-delivery interval? †
| Autor: | W.D. Ngan Kee, Anna Lee, Michael S. Rogers, Chi Chiu Wang, A.S.Y. Wong, Floria F. Ng, Kim S. Khaw |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Umbilical Veins medicine.medical_specialty Time Factors Randomization medicine.medical_treatment chemistry.chemical_element Anesthesia Spinal Oxygen Umbilical Arteries Fetus Double-Blind Method Pregnancy Anesthesia Obstetrical Humans Medicine Caesarean section Prospective Studies Maternal-Fetal Exchange Acidosis Cesarean Section business.industry Spinal anesthesia Venous blood Oxygenation Surgery Anesthesiology and Pain Medicine chemistry Oxyhemoglobins Anesthesia Arterial blood Female medicine.symptom business |
| Zdroj: | British Journal of Anaesthesia. 92:518-522 |
| ISSN: | 0007-0912 |
| Popis: | Background. The benefit of administering supplementary oxygen during elective Caesarean section under regional anaesthesia is controversial. It has been hypothesized that its use would improve fetal oxygenation in the event of a prolonged uterine incision-to-delivery (U‐D) interval. Our aim was to test this hypothesis in a prospective, randomized, double-blinded, controlled study. Methods. We allocated randomly 204 women having elective Caesarean section under spinal anaesthesia to breathe 21, 40 or 60% oxygen. We recorded the U‐D interval, umbilical arterial (UA) and venous (UV) blood gases and oxygen content and Apgar scores. Subgroup analysis was performed according to whether the U‐D interval was prolonged (>180 s) or not. Results. The U‐D interval was 180 s in 45 patients. There were no differences in UV or UA blood gases, oxygen content or Apgar scores between cases with and without a prolonged U‐D interval. In cases without a prolonged U‐D interval, administering 60% oxygen increased UV PO2 (mean 4.3 (SD 1.1) vs 3.7 (1.0) kPa, P=0.003) and oxygen content (14.4 (3.3) vs 12.9 (2.7) ml dl ‐1 , P=0.007) compared with air. In cases with a prolonged U‐ D interval, administering 60% oxygen increased UV PO2 (4.6 (0.6) vs 3.9 (0.8) kPa, P=0.019) compared with air but there was no difference in UV oxygen content. There was no increase in the UV PO2 or oxygen content when 40% oxygen was administered compared with air. Conclusions. Supplementary oxygen did not increase fetal oxygenation in cases where the U‐ D interval was prolonged. Our data do not support the routine administration of supplementary oxygen during elective Caesarean section for this purpose. Br J Anaesth 2004; 92: 518‐22 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|