Impact of spinal anaesthesia on peri-operative lung volumes in obese and morbidly obese female patients.
Although obesity predisposes to postoperative pulmonary complications, data on the relationship between body mass index (BMI) and peri-operative respiratory performance are limited. We prospectively studied the impact of spinal anaesthesia, obesity and vaginal surgery on lung volumes measured by spirometry in 28 patients with BMI 30-40 kg.m(-2) and in 13 patients with BMI > or = 40 kg.m(-2). Vital capacity, forced vital capacity, forced expiratory volume in 1 s, mid-expiratory and peak expiratory flows were measured during the pre-operative visit (baseline), after effective spinal anaesthesia with premedication, and after the operation at 20 min, 1 h, 2 h, and 3 h (after mobilisation). Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters. Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters; mean (SD) vital capacities were - 19% (6.4) in patients with BMI 30-40 kg.m(-2) and - 33% (9.0) in patients with BMI > 40 kg.m(-2). The decrease of lung volumes remained constant for 2 h, whereas 3 h after the operation and after mobilisation, spirometric parameters significantly improved in all patients. This study showed that both spinal anaesthesia and obesity significantly impaired peri-operative respiratory function.
Regli
A
A
Department of Anaesthesia and Operative Intensive Care, University of Basel Hospital, Spitalstrasse 21, 4031 Basel, Switzerland. aregli@uhbs.ch
von Ungern-Sternberg
B S
BS
Reber
A
A
Schneider
M C
MC
D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal; D000886:Anthropometry; D015992:Body Mass Index; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D009767:Obesity, Morbid / Q000503:physiopathology; D010366:Peak Expiratory Flow Rate; D011184:Postoperative Period; D011292:Premedication; D011446:Prospective Studies; D013147:Spirometry; D014797:Vital Capacity