Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study

Yıl: 2019 Cilt: 49 Sayı: 3 Sayfa Aralığı: 854 - 861 Metin Dili: İngilizce DOI: 10.3906/sag-1810-208 İndeks Tarihi: 11-05-2020

Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study

Öz:
Background/aim: In this study, it was aimed to investigate the relationship between body mass index (BMI) and cerebral oxygenationduring spinal anesthesia in women undergoing cesarean section. This study also aimed to demonstrate whether fetal cord bloodoxygenation was affected by maternal BMI and/or delivery time.Materials and methods: The study included parturients with ASA I score undergoing cesarean section under spinal anesthesia in 2015and 2016. They were divided into two groups according to BMI: Group 1 comprised parturients with BMI of <30 (n = 11) and Group 2comprised parturients with BMI of ≥30 (n = 17). Right cerebral oxygenation (RSO2) and left cerebral oxygenation (LSO2) monitoringwas performed using near-infrared spectroscopy (NIRS). The participants were divided into two groups according to the duration offetal delivery. Group A included parturients with delivery time of <2 min (n = 7) and Group B those with delivery time of >2 min (n =18), and fetal cord blood oxygenation was measured using a blood gas analyzer.Results: Evaluation was made of a total of 25 patients. The RSO2 values were measured at the 20th, 30th, and 35th minutes of thecesarean section procedure and the median values of all the time intervals in Group 1 were significantly lower than those of Group 2 (P< 0.05). The LSO2 value was significantly lower in Group 1 at the 35th minute compared to Group 2 (P < 0.05). The PO2 values of fetalcord blood were significantly lower in Group B (P < 0.05).Conclusion: The results of this study showed that parturients with BMI of <30 who are undergoing cesarean section under spinalanesthesia might have an increased risk of complications due to decreased cerebral oxygenation related with hypotension. Therefore,it can be suggested that before and during cesarean section these patients should be closely monitored for cerebral oxygenation usingNIRS.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Habib AS. A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia. Anesthesia and Analgesia 2012; 114 (2): 377-390. doi: 10.1213/ANE.0b013e3182373a3e
  • 2. Emmett RS, Cyna AM, Andrew M, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database of Systematic Reviews 2002; 3: CD002251. doi: 10.1002/14651858.CD002251
  • 3. Mercier FJ, Auge M, Hoffmann C, Fischer C, Le Gouez A. Maternal hypotension during spinal anesthesia for caesarean delivery. Minerva Anestesiologica 2013; 79 (1): 62-73.
  • 4. McDonald S, Fernando R, Ashpole K, Columb M. Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean delivery: a randomized controlled trial. Anesthesia and Analgesia 2011; 113 (4): 803-810. doi: 10.1213/ANE.0b013e31822c0f08
  • 5. Bhardwaj N, Jain K, Arora S, Bharti N. A comparison of three vasopressors for tight control of maternal blood pressure during cesarean section under spinal anesthesia: effect on maternal and fetal outcome. Journal of Anaesthesiology Clinical Pharmacology 2013; 29 (1): 26-31. doi: 10.4103/0970- 9185.105789
  • 6. Highton D, Elwell C, Smith M. Noninvasive cerebral oximetry: is there light at the end of the tunnel? Current Opinion in Anaesthesiology 2010; 23 (5): 576-581.
  • 7. Berlac PA, Rasmussen YH. Per-operative cerebral near-infrared spectroscopy (NIRS) predicts maternal hypotension. International Journal of Obstetric Anesthesia 2005; 14 (1): 26- 31. doi: 10.1016/j.ijoa.2004.06.003
  • 8. Kondo Y, Sakatani K, Hirose N, Maeda T, Kato J et al. Effect of spinal anesthesia for elective cesarean section on cerebral blood oxygenation changes: comparison of hyperbaric and isobaric bupivacaine. Advances in Experimental Medicine and Biology 2013; 765: 109-114. doi: 10.1007/978-1-4614-4989- 8_16
  • 9. Richardson BS, Ruttinger S, Brown HK, Regnault TRH, de Vrijer B. Maternal body mass index impacts fetal-placental size at birth and umbilical cord oxygen values with implications for regulatory mechanisms. Early Human Development 2017; 112: 42-47. doi: 10.1016/j.earlhumdev.2017.06.009
  • 10. Sebire NJ, Jolly M, Harris J, Regan L, Robinson S. Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London. British Journal of Obstetrics and Gynaecology 2001; 108 (1): 61-66.
  • 11. Kulkarni S, Gurudatt CL, Prakash D, Mathew JA. Effect of spinal flexion and extension in the lateral decubitus position on the unilaterality of spinal anesthesia using hyperbaric bupivacaine. Journal of Anaesthesiology Clinical Pharmacology 2018; 34 (4): 524-528. doi: 10.4103/joacp.JOACP_99_17
  • 12. Guarracino F. Cerebral monitoring during cardiovascular surgery. Current Opinion in Anaesthesiology 2008; 21 (1): 50- 54. doi: 10.1097/ACO.0b013e3282f3f499
  • 13. Thavasthy M, Broadhead M, Elwell C, Peters M, Smith M. A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 near‐infrared spectrophotometers. Anesthesia 2002; 57 (10): 999-1006. doi: 10.1046/j.1365- 2044.2002.02826.x
  • 14. Samra SK, Stanley JC, Zelenock GB, Dorje P. An assessment of contributions made by extracranial tissues during cerebral oximetry. Journal of Neurosurgical Anesthesiology 1999; 11 (1): 1-5.
  • 15. Watzman HM, Kurth CD, Montenegro LM, Rome J, Steven JM et al. Arterial and venous contributions to near‐infrared cerebral oximetry. Anesthesiology 2000; 93 (4): 947-953.
  • 16. Hirose N, Kondo Y, Maeda T, Suzuki T, Yoshino A. Relationship between regional cerebral blood volume and oxygenation and blood pressure during spinal anesthesia in women undergoing cesarean section. Journal of Anesthesia 2016: 30 (4): 603-609. doi: 10.1007/s00540-016-2165-6
  • 17. Sun S, Liu N, Huang S. Role of cerebral oxygenation for prediction of hypotension after spinal anesthesia for caesarean section. Journal of Clinical Monitoring and Computing 2016; 30 (4): 417-421. doi: 10.1007/s10877-015-9733-4
APA Aydın G, DAYANGAN SAYAN C (2019). Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. , 854 - 861. 10.3906/sag-1810-208
Chicago Aydın Gülçin,DAYANGAN SAYAN Cemile Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. (2019): 854 - 861. 10.3906/sag-1810-208
MLA Aydın Gülçin,DAYANGAN SAYAN Cemile Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. , 2019, ss.854 - 861. 10.3906/sag-1810-208
AMA Aydın G,DAYANGAN SAYAN C Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. . 2019; 854 - 861. 10.3906/sag-1810-208
Vancouver Aydın G,DAYANGAN SAYAN C Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. . 2019; 854 - 861. 10.3906/sag-1810-208
IEEE Aydın G,DAYANGAN SAYAN C "Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study." , ss.854 - 861, 2019. 10.3906/sag-1810-208
ISNAD Aydın, Gülçin - DAYANGAN SAYAN, Cemile. "Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study". (2019), 854-861. https://doi.org/10.3906/sag-1810-208
APA Aydın G, DAYANGAN SAYAN C (2019). Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. Turkish Journal of Medical Sciences, 49(3), 854 - 861. 10.3906/sag-1810-208
Chicago Aydın Gülçin,DAYANGAN SAYAN Cemile Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. Turkish Journal of Medical Sciences 49, no.3 (2019): 854 - 861. 10.3906/sag-1810-208
MLA Aydın Gülçin,DAYANGAN SAYAN Cemile Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. Turkish Journal of Medical Sciences, vol.49, no.3, 2019, ss.854 - 861. 10.3906/sag-1810-208
AMA Aydın G,DAYANGAN SAYAN C Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. Turkish Journal of Medical Sciences. 2019; 49(3): 854 - 861. 10.3906/sag-1810-208
Vancouver Aydın G,DAYANGAN SAYAN C Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study. Turkish Journal of Medical Sciences. 2019; 49(3): 854 - 861. 10.3906/sag-1810-208
IEEE Aydın G,DAYANGAN SAYAN C "Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study." Turkish Journal of Medical Sciences, 49, ss.854 - 861, 2019. 10.3906/sag-1810-208
ISNAD Aydın, Gülçin - DAYANGAN SAYAN, Cemile. "Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study". Turkish Journal of Medical Sciences 49/3 (2019), 854-861. https://doi.org/10.3906/sag-1810-208