Supplemental maternal oxygen therapy during caesarean section under epidural anaesthesia: a comparison of nasal prongs and facemask.
Forty healthy parturients at term, undergoing elective Caesarean section, were divided into two groups to receive supplemental oxygen by either simple facemask (Group FM, 8 L.min-1) or nasal prongs (Group NP, 4 L.min-1) during the procedure. Anaesthesia was provided by epidural block to equivalent dermatomal levels in all patients. Maternal oxygen saturation was measured continuously with pulse oximetry and supplemental oxygen was provided to the mother after administration of the epidural test dose and continued until the end of the procedure. Following delivery of the infant and concurrent with Apgar scoring, the umbilical cord was double-clamped and arterial and venous samples were drawn. The pH, partial pressures of O2 and CO2 and O2 saturations were measured. There was no difference in the clinical condition of the neonates, as assessed by Apgar scores, or in the acid-base and oxygenation status, as assessed by blood gas analyses between the two groups. Mean umbilical vein oxygen saturation, a measure of fetal oxygen delivery, was 46 +/- 18% (95% confidence interval 39% to 54%) for Group NP and 54 +/- 17% (95% confidence interval 46% to 62%) for Group FM, again not different. We conclude that when the clinical condition, acid-base and oxygenation status of neonates, delivered by elective Caesarean section to healthy, low-risk parturients with normal placental function under epidural anaesthesia, are evaluated, it makes no difference whether the mothers received supplemental oxygen by nasal prongs or simple facemask.
Crosby
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ET
Department of Anaesthesia, Ottawa General Hospital, University of Ottawa, Toronto, Canada.
Halpern
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SH
D000136:Acid-Base Equilibrium; D000281:Administration, Intranasal; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001034:Apgar Score; D001794:Blood Pressure; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D008397:Masks; D008431:Maternal-Fetal Exchange; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation*; D010313:Partial Pressure; D011247:Pregnancy; D013997:Time Factors
D010100:Oxygen