Regional anesthesia for cesarean section in obese pregnant women: a retrospective study

The objective of the data gathering was to identify anesthetic techniques, and their difficulties and complications in patients with BMI ≥ 30 kg.m(-2) undergoing cesarean sections. The study intends to support the development of new protocols and more adequate conducts for this population of pregnant women.

This is a retrospective study of data and anesthetic complications in obese patients older than 18 years of age who underwent cesarean sections from January 2004 to December 2006; variables investigated included: age, weight, height, BMI, physical status (ASA), anesthetic techniques, difficulties in palpation and puncturing, hemodynamic complications (bleeding and hypotension), and anesthetic complications.

Three hundred and fifteen anesthetic forms were evaluated. Mean age was 29.1 years, mean BMI 39.25, and the majority of patients was classified as ASA II (63.2%). Spinal anesthesia charts used more often, difficulty to puncture was reported in 47 procedures, and difficulty to palpate was reported in 31 procedures.

Technical difficulties as well as hypotension, bleeding, and surgical time were more frequent in patients with higher degrees of obesity.