Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T09:48:33.936Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of maternal facial oxygen on neonatal behavioural scores during elective Caesarean section with spinal anaesthesia

Published online by Cambridge University Press:  08 August 2006

S. K. Backe ,
M. Kocarev ,
R. C. Wilson  and
G. Lyons
S. K. Backe
Affiliation:
Wansbeck General Hospital, Department of Anaesthesia, Ashington, Leeds, UK
M. Kocarev
Affiliation:
St James University Hospital, Department of Obstetric Anaesthesia, Leeds, UK
R. C. Wilson
Affiliation:
St James University Hospital, Department of Obstetric Anaesthesia, Leeds, UK
G. Lyons
Affiliation:
St James University Hospital, Department of Obstetric Anaesthesia, Leeds, UK
Get access

Extract

Summary

Background and objective: For many, the administration of additional oxygen to the women receiving regional anaesthesia for Caesarean section is traditional, but for others it is controversial because of doubts about its efficacy. The aim of our study was to determine if beneficial effects of maternal oxygen therapy on the fetus could be revealed using a neonatal behavioural scoring system. Methods: Sixty women with a normal singleton pregnancy beyond 36 weeks gestation, undergoing elective Caesarean section under spinal anaesthesia were randomized into two groups: Group 1 received air and oxygen mixture through a Hudson style face mask (FiO2 of 0.21–0.25). Group 2 received FiO2 of 0.40–0.60 through an identical Hudson style face mask. Neurologic Adaptive Capacity Score on all the infants within 5 min of birth and between 10 and 24 h after the Caesarean delivery was performed. Apgar score, umbilical venous blood oxygen tension and umbilical artery standardized base excess were recorded. Results: Initial Neurologic Adaptive Capacity Scores at birth in Groups 1 and 2 were 32.6 (SD 4.6) and 31.3 (SD 4.3), respectively. Latter scores were 36.0 (SD 3.0) and 36.5 (SD 1.9), respectively. Neither were statistically significant. There were no significant differences between the groups for any of the recorded variables. Conclusions: Administering maternal oxygen using a standard commercial Hudson style face mask does not appear to significantly improve oxygen delivery to, nor does it influence acidosis or behavioural effects in, the normal neonate at elective Caesarean delivery with spinal anaesthesia.

Keywords

ANAESTHESIA TECHNIQUES, OBSTETRICANAESTHESIA, SPINALCAESAREAN SECTIONINFANT, NEWBORNOXYGEN THERAPY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 1 , January 2007 , pp. 66 - 70
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Thomas J, Paranjothy S. Royal College of Obstetricians and Gynaecologist Clinical Effectiveness Support Unit. National Sentinel Caesarean Section Audit Report. RCOG Press, 2001.
Shnider S, Levinson G. Anesthesia for Caesarean section. In: Shnider S, Levinson G, eds. Anesthesia for Obstetrics, 3rd edn. Philadelphia, USA: Williams and Wilkins, 1993: 217.
Marx GF, Mateo CV. Effects of different oxygen concentration during general anaesthesia for elective Caesarean section. Can Anaesth Soc J 1971; 18: 587–593.Google Scholar
Crawford JS. Principles and Practice of Obstetrics Anaesthesia, 5th edn. Oxford, UK: Blackwell Scientific Publications, 1984: 303.
Conn DA, Moffat AC, McCallum GDR, Thorburn J. Changes in pulmonary function tests during spinal anaesthesia for Caesarean section. Int J Obs Anesth 1993; 2: 12–14.Google Scholar
Kelly MC, Fitzpatrick KTJ, Hill DA. Respiratory effects of spinal anaesthesia for Caesarean section. Anaesthesia 1996; 51: 1120–1122.Google Scholar
Ramanathan S, Gandhi S, Arismendy J, Chalon J, Turndorf H. Oxygen transfer from mother to fetus during cesarean section under epidural anesthesia. Anesth Analg 1982; 61: 576–581.Google Scholar
Khaw KS, Wang CC, Ngan Kee WD, Pang CP, Rogers MS. The effects of high inspired oxygen fraction during elective caesarean section under spinal anaesthesia on maternal and fetal oxygenation and lipid-peroxidation. Br J Anaesth 2002; 88: 18–23.Google Scholar
Vento M, Asensi M, Sastre J, Garcia-Sala F, Pallardo FV, Vina J. Resuscitation with room air instead of 100% oxygen prevents oxidative stress in moderately asphyxiated term neonates. Pediatrics 2001; 107: 642–647.Google Scholar
Amiel-Tison C, Barrier G, Shnider SM, Levinson G, Hughes SC, Stefani SJ. A new neurological and adaptive scoring system for evaluating obstetrics medications in full-term newborns. Anesthesiology 1982; 56: 340–350.Google Scholar
Ngan Kee WD, Khaw KS, Ma KC, Wong ASY, Lee BB. Randomized, double-blind comparison of different inspired oxygen fractions during general anaesthesia for Caesarean section. Br J Anaesth 2002; 89: 556–561.Google Scholar
Brockhurst NJ, Littleford JA, Halpern SH. The neurologic adaptive and capacity score: a systematic review of its use in obstetric anesthesia research. Anesthesiology 2000; 92: 237–246.Google Scholar
Halpern SH, Littleford JA, Brockhurst NJ, Youngs PJ, Malik N, Owen HC. The neurologic and adaptive capacity score is not a reliable method of newborn evaluation. Anesthesiology 2001; 94: 958–962.Google Scholar
Cammann W, Brazelton TB. Use and abuse of neonatal neurobehavioral testing. Anesthesiology 2000; 92: 3–5.Google Scholar