Supplementary oxygen for emergency Caesarean section under regional anaesthesia
Background Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under re...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2009-01, Vol.102 (1), p.90-96 |
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| creator | Khaw, K. S. Wang, C. C. Ngan Kee, W. D. Tam, W. H. Ng, F. F. Critchley, L. A. H. Rogers, M. S. |
| description | Background Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. Methods We recruited 131 women having emergency CS under regional anaesthesia. Either 21% (air group) or 60% oxygen (oxygen group) was administered using a Venturi-type facemask until delivery. We compared the oxygen exposure duration, umbilical arterial (UA) and venous (UV) blood gases and oxygen content, and plasma concentration of 8-isoprostane. Subanalysis was performed according to whether or not fetal compromise was considered present. Results Data from 125 patients were analysed. For the oxygen group vs the air group, there were greater values for UA Po2 [mean 2.2 (sd 0.5) vs 1.9 (0.6) kPa, P=0.01], UA O2 content [6.6 (2.5) vs 4.9 (2.8) ml dl−1, P=0.006], UV Po2 [3.8 (0.8) vs 3.2 (0.8) kPa, P |
| doi_str_mv | 10.1093/bja/aen321 |
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S. ; Wang, C. C. ; Ngan Kee, W. D. ; Tam, W. H. ; Ng, F. F. ; Critchley, L. A. H. ; Rogers, M. S.</creator><creatorcontrib>Khaw, K. S. ; Wang, C. C. ; Ngan Kee, W. D. ; Tam, W. H. ; Ng, F. F. ; Critchley, L. A. H. ; Rogers, M. S.</creatorcontrib><description>Background Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. Methods We recruited 131 women having emergency CS under regional anaesthesia. Either 21% (air group) or 60% oxygen (oxygen group) was administered using a Venturi-type facemask until delivery. We compared the oxygen exposure duration, umbilical arterial (UA) and venous (UV) blood gases and oxygen content, and plasma concentration of 8-isoprostane. Subanalysis was performed according to whether or not fetal compromise was considered present. Results Data from 125 patients were analysed. For the oxygen group vs the air group, there were greater values for UA Po2 [mean 2.2 (sd 0.5) vs 1.9 (0.6) kPa, P=0.01], UA O2 content [6.6 (2.5) vs 4.9 (2.8) ml dl−1, P=0.006], UV Po2 [3.8 (0.8) vs 3.2 (0.8) kPa, P<0.0001], and UV O2 content [12.9 (3.5) vs 10.4 (3.8) ml dl−1, P=0.001]. There was no difference between the groups in maternal, UA, or UV 8-isoprostane concentration. Apgar scores and UA pH were similar between the groups. Similar changes were observed regardless of whether fetal compromise was considered present (n=37) or not (n=88). Conclusions Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aen321</identifier><identifier>PMID: 19011261</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adult ; anaesthetic techniques ; Anesthesia ; Anesthesia, Conduction - methods ; Anesthesia, Obstetrical - methods ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Apgar Score ; Biological and medical sciences ; Cesarean Section ; Double-Blind Method ; Emergencies ; Female ; fetal ; Fetal Blood - metabolism ; Humans ; Lipid Peroxidation ; Medical sciences ; Middle Aged ; oxygen ; Oxygen - blood ; Oxygen Inhalation Therapy - adverse effects ; Oxyhemoglobins - metabolism ; Partial Pressure ; Pregnancy ; Prospective Studies ; regional ; therapy ; toxicity ; Young Adult</subject><ispartof>British journal of anaesthesia : BJA, 2009-01, Vol.102 (1), p.90-96</ispartof><rights>The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2009</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Oxford Publishing Limited(England) Jan 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-5dc62f2f7415669c743de5b865b1d098f4625905bdb8bbb44a84003a492929e3</citedby><cites>FETCH-LOGICAL-c446t-5dc62f2f7415669c743de5b865b1d098f4625905bdb8bbb44a84003a492929e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21100426$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19011261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khaw, K. S.</creatorcontrib><creatorcontrib>Wang, C. C.</creatorcontrib><creatorcontrib>Ngan Kee, W. D.</creatorcontrib><creatorcontrib>Tam, W. H.</creatorcontrib><creatorcontrib>Ng, F. F.</creatorcontrib><creatorcontrib>Critchley, L. A. H.</creatorcontrib><creatorcontrib>Rogers, M. S.</creatorcontrib><title>Supplementary oxygen for emergency Caesarean section under regional anaesthesia</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><addtitle>Br J Anaesth</addtitle><description>Background Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. Methods We recruited 131 women having emergency CS under regional anaesthesia. Either 21% (air group) or 60% oxygen (oxygen group) was administered using a Venturi-type facemask until delivery. We compared the oxygen exposure duration, umbilical arterial (UA) and venous (UV) blood gases and oxygen content, and plasma concentration of 8-isoprostane. Subanalysis was performed according to whether or not fetal compromise was considered present. Results Data from 125 patients were analysed. For the oxygen group vs the air group, there were greater values for UA Po2 [mean 2.2 (sd 0.5) vs 1.9 (0.6) kPa, P=0.01], UA O2 content [6.6 (2.5) vs 4.9 (2.8) ml dl−1, P=0.006], UV Po2 [3.8 (0.8) vs 3.2 (0.8) kPa, P<0.0001], and UV O2 content [12.9 (3.5) vs 10.4 (3.8) ml dl−1, P=0.001]. There was no difference between the groups in maternal, UA, or UV 8-isoprostane concentration. Apgar scores and UA pH were similar between the groups. Similar changes were observed regardless of whether fetal compromise was considered present (n=37) or not (n=88). Conclusions Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.</description><subject>Adolescent</subject><subject>Adult</subject><subject>anaesthetic techniques</subject><subject>Anesthesia</subject><subject>Anesthesia, Conduction - methods</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Apgar Score</subject><subject>Biological and medical sciences</subject><subject>Cesarean Section</subject><subject>Double-Blind Method</subject><subject>Emergencies</subject><subject>Female</subject><subject>fetal</subject><subject>Fetal Blood - metabolism</subject><subject>Humans</subject><subject>Lipid Peroxidation</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>oxygen</subject><subject>Oxygen - blood</subject><subject>Oxygen Inhalation Therapy - adverse effects</subject><subject>Oxyhemoglobins - metabolism</subject><subject>Partial Pressure</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>regional</subject><subject>therapy</subject><subject>toxicity</subject><subject>Young Adult</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90Etr3DAQB3BREppN2ks_QDCB5FBwo5H1sI5hyaMQCKU5lF6EJI8Tb72yK9mw--2jsksCPQQd9ODHzOhPyBeg34Dq6tKt7KXFUDH4QBbAFZRSKTggC0qpKqkGdkSOU1pRCopp8ZEcgaYATMKCPPycx7HHNYbJxm0xbLZPGIp2iEV-i_nst8XSYrIRbSgS-qkbQjGHBmMR8SlfbF_YkMX0jKmzn8hha_uEn_f7CXm8uX5c3pX3D7ffl1f3pedcTqVovGQtaxUHIaX2ilcNCldL4aChum65ZEJT4RpXO-c4tzWntLJcs7ywOiEXu7JjHP7OublZd8lj39uAw5yMlPmnStQZnv0HV8Mc89DJgFY1yz1YRl93yMchpYitGWO3znkYoOZfxCZHbHYRZ3y6rzi7NTZvdJ9pBud7YJO3fRtt8F16dQyAUs7kmxvm8f2G5c51acLNq7Txj5GqUsLc_fptbqofmt4KYerqBeJQn1w</recordid><startdate>200901</startdate><enddate>200901</enddate><creator>Khaw, K. S.</creator><creator>Wang, C. C.</creator><creator>Ngan Kee, W. D.</creator><creator>Tam, W. H.</creator><creator>Ng, F. F.</creator><creator>Critchley, L. A. H.</creator><creator>Rogers, M. S.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200901</creationdate><title>Supplementary oxygen for emergency Caesarean section under regional anaesthesia</title><author>Khaw, K. S. ; Wang, C. C. ; Ngan Kee, W. D. ; Tam, W. H. ; Ng, F. F. ; Critchley, L. A. H. ; Rogers, M. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-5dc62f2f7415669c743de5b865b1d098f4625905bdb8bbb44a84003a492929e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>anaesthetic techniques</topic><topic>Anesthesia</topic><topic>Anesthesia, Conduction - methods</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Apgar Score</topic><topic>Biological and medical sciences</topic><topic>Cesarean Section</topic><topic>Double-Blind Method</topic><topic>Emergencies</topic><topic>Female</topic><topic>fetal</topic><topic>Fetal Blood - metabolism</topic><topic>Humans</topic><topic>Lipid Peroxidation</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>oxygen</topic><topic>Oxygen - blood</topic><topic>Oxygen Inhalation Therapy - adverse effects</topic><topic>Oxyhemoglobins - metabolism</topic><topic>Partial Pressure</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>regional</topic><topic>therapy</topic><topic>toxicity</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khaw, K. S.</creatorcontrib><creatorcontrib>Wang, C. C.</creatorcontrib><creatorcontrib>Ngan Kee, W. D.</creatorcontrib><creatorcontrib>Tam, W. H.</creatorcontrib><creatorcontrib>Ng, F. F.</creatorcontrib><creatorcontrib>Critchley, L. A. H.</creatorcontrib><creatorcontrib>Rogers, M. S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khaw, K. S.</au><au>Wang, C. C.</au><au>Ngan Kee, W. D.</au><au>Tam, W. H.</au><au>Ng, F. F.</au><au>Critchley, L. A. H.</au><au>Rogers, M. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Supplementary oxygen for emergency Caesarean section under regional anaesthesia</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br J Anaesth</stitle><addtitle>Br J Anaesth</addtitle><date>2009-01</date><risdate>2009</risdate><volume>102</volume><issue>1</issue><spage>90</spage><epage>96</epage><pages>90-96</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>Background Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. Methods We recruited 131 women having emergency CS under regional anaesthesia. Either 21% (air group) or 60% oxygen (oxygen group) was administered using a Venturi-type facemask until delivery. We compared the oxygen exposure duration, umbilical arterial (UA) and venous (UV) blood gases and oxygen content, and plasma concentration of 8-isoprostane. Subanalysis was performed according to whether or not fetal compromise was considered present. Results Data from 125 patients were analysed. For the oxygen group vs the air group, there were greater values for UA Po2 [mean 2.2 (sd 0.5) vs 1.9 (0.6) kPa, P=0.01], UA O2 content [6.6 (2.5) vs 4.9 (2.8) ml dl−1, P=0.006], UV Po2 [3.8 (0.8) vs 3.2 (0.8) kPa, P<0.0001], and UV O2 content [12.9 (3.5) vs 10.4 (3.8) ml dl−1, P=0.001]. There was no difference between the groups in maternal, UA, or UV 8-isoprostane concentration. Apgar scores and UA pH were similar between the groups. Similar changes were observed regardless of whether fetal compromise was considered present (n=37) or not (n=88). Conclusions Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>19011261</pmid><doi>10.1093/bja/aen321</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult anaesthetic techniques Anesthesia Anesthesia, Conduction - methods Anesthesia, Obstetrical - methods Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Apgar Score Biological and medical sciences Cesarean Section Double-Blind Method Emergencies Female fetal Fetal Blood - metabolism Humans Lipid Peroxidation Medical sciences Middle Aged oxygen Oxygen - blood Oxygen Inhalation Therapy - adverse effects Oxyhemoglobins - metabolism Partial Pressure Pregnancy Prospective Studies regional therapy toxicity Young Adult |
| title | Supplementary oxygen for emergency Caesarean section under regional anaesthesia |
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