British Journal of Anaesthesia, 2004, Vol. 92, No. 4 518-522
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia
Clinical Investigations |
Supplementary oxygen for elective Caesarean section under spinal anaesthesia: useful in prolonged uterine incision-to-delivery interval?
1 Department of Anaesthesia and Intensive Care and 2 Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
*Corresponding author: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China. E-mail: KimKhaw@cuhk.edu.hk 
Presented as a poster at The South African Society of Anaesthesiologists Congress, Sun City, South Africa, 14–20 March 2003.
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 159 patients and >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
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Van de Velde Emergency Caesarean delivery: is supplementary maternal oxygen necessary? Br. J. Anaesth., January 1, 2009; 102(1): 1 - 2. [Full Text] [PDF]
|
|
|
|
|
|
K. S. Khaw, C. C. Wang, W. D. Ngan Kee, W. H. Tam, F. F. Ng, L. A. H. Critchley, and M. S. Rogers Supplementary oxygen for emergency Caesarean section under regional anaesthesia, Br. J. Anaesth., January 1, 2009; 102(1): 90 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Iscoe and J. A. Fisher Hyperoxia-Induced Hypocapnia: An Underappreciated Risk Chest, July 1, 2005; 128(1): 430 - 433. [Full Text] [PDF]
|
|
|
|
|
|
N. G. Mandal, A. Gulati, K. S. Khaw, and W. Ngan Kee Oxygen supplementation during Caesarean delivery Br. J. Anaesth., September 1, 2004; 93(3): 469 - 470. [Full Text] [PDF]
|
|