Pulmonary Function Changes during Epidural Anesthesia for Cesarean Delivery

Yun, Esther; Bader, Angela M.; Topulos, George P.; Body, Simon C.; Datta, Sujata

doi:10.1097/00000542-199409001-01164

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“…Although these parturients are particularly at risk for pulmonary complications resulting from changes induced by pregnancy and obesity, there are no reported controlled trials on the impairment of peri-operative respiratory function in this subgroup. There are some reports on the respiratory effects of SA and epidural anaesthesia for Caesarean section in normal weight parturients [12][13][14][15][16], and only a small study on the effect of SA in obese, albeit non-pregnant, patients [5]. Thus, the present prospective study was designed to evaluate both normal weight and obese parturients scheduled for elective Caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Impact of spinal anaesthesia and obesity on maternal respiratory function during elective Caesarean section*

Ungern‐Sternberg¹,

Regli²,

Bucher³

et al. 2004

Anaesthesia

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SummarySpinal anaesthesia for Caesarean section has gained widespread acceptance. We assessed the impact of spinal anaesthesia and body mass index (BMI) on spirometric performance. In this prospective study, we consecutively assessed 71 consenting parturients receiving spinal anaesthesia with hyperbaric bupivacaine and fentanyl for elective Caesarean section. We performed spirometry during the antepartum visit (baseline), immediately after spinal anaesthesia, 10-20 min, 1 h, 2 h after the operation, and after mobilisation (3 h). Baseline values were within normal ranges. There was a significant decrease in all spirometric parameters after effective spinal anaesthesia that persisted throughout the study period. The decrease in respiratory function was significantly greater in obese (BMI > 30 kg.m )2 ) than in normal-weight parturients (BMI < 25 kg.m )2 ), e.g. median (IQR) vital capacity directly after spinal anaesthesia; )24 ()16 to )31)% vs. )11 ()6 to )16)%, p < 0.001 and recovery was significantly slower. We conclude that both spinal anaesthesia and obesity significantly impair respiratory function in parturients.

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