title: Supplemental oxygen in elective cesarean section under spinal anesthesia: Handle the sword with care.
abstract: OBJECTIVE
  We aimed to investigate the effect of 21% and 40% oxygen supplementation on maternal and neonatal oxidative stress in elective cesarean section (CS) under spinal anesthesia.
  
  
  METHODS
  Eighty term parturients undergoing elective CS under spinal anesthesia were enrolled in the study. We allocated patients randomly to breathe 21% (air group) or 40% (oxygen group) oxygen from the time of skin incision until the end of the operation. We collected maternal pre- and post-operative and umbilical artery (UA) blood samples. Total antioxidant capacity (TAC), total oxidant status (TOS) and the oxidative stress index (OSI) were measured.
  
  
  RESULTS
  Age, weight, height, parity, gestation week, spinal-skin incision time, skin incision-delivery time, delivery time, operation time, 1(st) and 5(th) minutes Apgar scores, and birth weight were similar between the groups (p > 0.05 for all comparisons). There were no differences in preoperative TAC, TOS, or OSI levels between the groups (p > 0.05 for all comparisons). Postoperative maternal TAC, TOS and OSI levels significantly increased in the oxygen group (p = 0.047, < 0.001 and 0.038, respectively); umbilical artery TAC levels significantly increased in the oxygen group (p = 0.003); and umbilical artery TOS and OSI levels significantly increased in the air group (p = 0.02 and < 0.001, respectively).
  
  
  CONCLUSIONS
  The difference in impact on maternal and fetal oxidative stress of supplemental 40% compared to 21% oxygen mandates further large-scale studies that investigate the role of oxygen supplementation during elective CS under spinal anesthesia.
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey. Electronic address: sabanyalcin@yahoo.com.
authors.forename: Saban
authors.initials: S
authors.lastname: Yalcin
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Aydoğan
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kucuk
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Hasan Husnu
authors.initials: HH
authors.lastname: Yuce
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Nuray
authors.initials: N
authors.lastname: Altay
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Mahmut Alp
authors.initials: MA
authors.lastname: Karahan
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Buyukfirat
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Camuzcuoğlu
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Incebiyik
authors.affiliation: Department of Chest Disease, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Yalcin
authors.affiliation: Department of Clinical Biochemistry, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Aksoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section / Q000379:methods*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018384:Oxidative Stress; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011247:Pregnancy; D055815:Young Adult
keywords: Anesthesia; Cesarean Section; Oxidative Stress; Oxygen; Oxygen Inhalation Therapy; Spinal