Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia

This was a prospective observational study to identify the incidence and possible risk factors for maternal desaturation following neuraxial blockade for elective caesarean section (CS). Patients with body mass index (BMI) ≥ 30 kg/m2 at the first antenatal consultation were identified and classified...

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Main Authors:	Farhana K, Lee, Choon Yee, Thohiroh AR
Format:	Article
Language:	English
Published:	Pusat Perubatan Universiti Kebangsaan Malaysia 2017
Online Access:	http://journalarticle.ukm.my/12267/ http://journalarticle.ukm.my/12267/ http://journalarticle.ukm.my/12267/1/6._farhana_et_al.pdf

id	ukm-12267
recordtype	eprints
spelling	ukm-122672018-11-02T21:23:39Z http://journalarticle.ukm.my/12267/ Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia Farhana K, Lee, Choon Yee Thohiroh AR, This was a prospective observational study to identify the incidence and possible risk factors for maternal desaturation following neuraxial blockade for elective caesarean section (CS). Patients with body mass index (BMI) ≥ 30 kg/m2 at the first antenatal consultation were identified and classified into the obese group. Neuraxial blockade in the form of subarachnoid block (SAB) or combined spinal-epidural (CSE) was performed. Mean arterial pressure (MAP) and oxygen saturation (SpO2) were recorded at baseline and at 5-minute intervals following neuraxial blockade. Desaturation, defined as SpO2 < 94% for more than 30 seconds without artifacts, was managed with oxygen therapy and other appropriate measures. Newborn Apgar score and umbilical cord blood gases were analysed. Among a total of 254 recruited patients, 69 (27.2%) were obese and were associated with significantly higher age, parity, previous CS and pre-existing diabetes mellitus. The incidence of oxygen desaturation was 1.2%, involving three patients in the non obese group. These desaturation episodes were short-lived and associated with intraoperative hypotension. Six patients, two of whom in the obese group, received rescue oxygen therapy following intraoperative events such as deteriorating SpO2 or hypotension. The mean MAP was significantly lower at baseline and at 5 minutes post neuraxial blockade in the non obese group, which could account for the occurrence of desaturation in this group only. There were no significant inter-group differences in terms of neonatal outcome, umbilical cord blood gases and changes in mean SpO2 post neuraxial blockade. In conclusion, the current practice of not routinely giving supplementary oxygen to patient during elective CS at our institution is deemed to be safe, provided continuous SpO2 monitoring is available throughout the surgery. Further randomised clinical trials are indicated to investigate the impact of maternal obesity and of labouring patients presenting for urgent or emergency CS on intraoperative oxygen desaturation. Pusat Perubatan Universiti Kebangsaan Malaysia 2017 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/12267/1/6._farhana_et_al.pdf Farhana K, and Lee, Choon Yee and Thohiroh AR, (2017) Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia. Journal of Surgical Academia, 7 (1). pp. 29-37. ISSN 2231-7481 http://jsurgacad.com/toc/7/1
repository_type	Digital Repository
institution_category	Local University
institution	Universiti Kebangasaan Malaysia
building	UKM Institutional Repository
collection	Online Access
language	English
description	This was a prospective observational study to identify the incidence and possible risk factors for maternal desaturation following neuraxial blockade for elective caesarean section (CS). Patients with body mass index (BMI) ≥ 30 kg/m2 at the first antenatal consultation were identified and classified into the obese group. Neuraxial blockade in the form of subarachnoid block (SAB) or combined spinal-epidural (CSE) was performed. Mean arterial pressure (MAP) and oxygen saturation (SpO2) were recorded at baseline and at 5-minute intervals following neuraxial blockade. Desaturation, defined as SpO2 < 94% for more than 30 seconds without artifacts, was managed with oxygen therapy and other appropriate measures. Newborn Apgar score and umbilical cord blood gases were analysed. Among a total of 254 recruited patients, 69 (27.2%) were obese and were associated with significantly higher age, parity, previous CS and pre-existing diabetes mellitus. The incidence of oxygen desaturation was 1.2%, involving three patients in the non obese group. These desaturation episodes were short-lived and associated with intraoperative hypotension. Six patients, two of whom in the obese group, received rescue oxygen therapy following intraoperative events such as deteriorating SpO2 or hypotension. The mean MAP was significantly lower at baseline and at 5 minutes post neuraxial blockade in the non obese group, which could account for the occurrence of desaturation in this group only. There were no significant inter-group differences in terms of neonatal outcome, umbilical cord blood gases and changes in mean SpO2 post neuraxial blockade. In conclusion, the current practice of not routinely giving supplementary oxygen to patient during elective CS at our institution is deemed to be safe, provided continuous SpO2 monitoring is available throughout the surgery. Further randomised clinical trials are indicated to investigate the impact of maternal obesity and of labouring patients presenting for urgent or emergency CS on intraoperative oxygen desaturation.
format	Article
author	Farhana K, Lee, Choon Yee Thohiroh AR,
spellingShingle	Farhana K, Lee, Choon Yee Thohiroh AR, Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
author_facet	Farhana K, Lee, Choon Yee Thohiroh AR,
author_sort	Farhana K,
title	Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
title_short	Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
title_full	Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
title_fullStr	Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
title_full_unstemmed	Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
title_sort	incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia
publisher	Pusat Perubatan Universiti Kebangsaan Malaysia
publishDate	2017
url	http://journalarticle.ukm.my/12267/ http://journalarticle.ukm.my/12267/ http://journalarticle.ukm.my/12267/1/6._farhana_et_al.pdf
first_indexed	2023-09-18T20:02:13Z
last_indexed	2023-09-18T20:02:13Z
_version_	1777406924753469440

Incidence of maternal desaturation among patients undergoing elective caesaraen section under regional anaesthesia

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