SUPPLEMENTAL OXYGEN FOR CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

Abstract

Background: Routine administration of supplemental oxygen to parturients undergoing
Caesarean section under spinal anaesthesia has been criticised in recent times.
Objectives: To assess the need for routine supplementary oxygen in healthy women
undergoing Caesarean section under spinal anaesthesia in resource challenged setting
and establish the efficacy of administration of oxygen at 4L/min.
Design: Simple randomized trial using sealed envelopes.
Setting: The Obafemi Awolowo University Teaching Hospital; a 580 bed hospital
situated in Ile-Ife in South-western Nigeria.
Subjects: Seventy parturients with ASA physical status I or Il undergoing Caesarean section under spinal anaesthesia.
Main outcome measures: Outcome measures were arterial oxygen saturation (SaO2) and Apgar scores at one and five minutes.
Results: The mean pre-induction arterial oxygen saturation in the two groups were
similar. There was a statistically significant difference in the mean SaO2 at one minute
between the two groups, with the control group being higher (97.7% ± 1.5% versus.
96.7% ± 1.5%; p-value = 0.008). The mean least SaO2 during surgery was also higher in
the control group (95.9% ± 1.5% versus 94.9% ± 2.0%, p-value = 0.015). The Apgar score
of the babies at one and five minutes for the study and control group were similar.
Conclusion: Healthy parturients undergoing Caesarean section under spinal anaesthesia
do well without supplemental oxygen; administration of supplemental oxygen from
the common gas outlet of anaesthetic machine with the breathing circuit and standard
anaesthetic facemask at 4L/min causes relative desaturation.