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Supplemental oxygen for caesarean section under spinal anaesthesia
A T Adenekan1, A F Faponle, E A Azebi
1Department of Anaesthesia, Obafemi Awolowo University Teaching Hospital, PMB 5538, Ile-Ife, Nigeria.
Background:
Routine administration of supplemental oxygen to parturients undergoing Caesarean section under spinal anaesthesia has been criticised in recent times.
Objectives:
To assess the need for routine supplementary oxygen in healthy women undergoing Caesarean section under spinal anaesthesia in resource challenged setting and establish the efficacy of administration of oxygen at 4L/min.
Design:
Simple randomized trial using sealed envelopes.
Setting:
The Obafemi Awolowo University Teaching Hospital; a 580 bed hospital situated in Ile-Ife in South-western Nigeria.
Subjects:
Seventy parturients with ASA physical status I or II undergoing Caesarean section under spinal anaesthesia.
Main Outcome Measures:
Outcome measures were arterial oxygen saturation (SaO2) and Apgar scores at one and five minutes.
Results:
The mean pre-induction arterial oxygen saturation in the two groups were similar. There was a statistically significant difference in the mean SaO2 at one minute between the two groups, with the control group being higher (97.7% +/- 1.5% versus. 96.7% +/- 1.5%; p-value = 0.008). The mean least SaO2 during surgery was also higher in the control group (95.9% +/- 1.5% versus 94.9% +/- 2.0%, p-value = 0.015). The Apgar score of the babies at one and five minutes for the study and control group were similar.
Conclusion:
Healthy parturients undergoing Caesarean section under spinal anaesthesia do well without supplemental oxygen; administration of supplemental oxygen from the common gas outlet of anaesthetic machine with the breathing circuit and standard anaesthetic facemask at 4L/min causes relative desaturation.
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