Electrogastrography during and after cesarean delivery

Abstract

Although it has been generally believed that parturients have delayed gastric emptying during anesthesia, the most recent reports suggest that gastric emptying is not delayed during pregnancy except during labor. Electrical slow waves in the stomach determine the frequency and the peristaltic nature of gastric contractions. In this study we performed electrogastrography during and after elective cesarean section (CS) in an attempt to evaluate gastric motility. Sixteen American Society of Anesthesiologists physical status I or II term parturients undergoing elective CS were enrolled. Combined spinal-epidural anesthesia was initiated with 10 mg of bupivacaine plus 10 microg of fentanyl. Four-channel electrogastrography was obtained for 10 min prior to venous catheter insertion (baseline), 10 min following spinal injection of bupivacaine and fentanyl (Sp-1), 10 to 20 min following spinal injection (Sp-2), 10 min prior to the end of operation (end), and finally 10 min on the seventh postoperative day (POD 7). The mean +/- SD values for dominant frequency of electrogastrography (DF) were determined as: 1.57 +/- 0.36 cpm (baseline), 1.81 +/- 0.32 cpm (Sp-1), 2.08 +/- 0.36 cpm (Sp-2), 1.96 +/- 0.36 cpm (end), and 3.02 +/- 0.28 cpm (POD 7). The DF of Sp-1, Sp-2, and end were significantly higher than that of baseline (P < 0.05). The DF of POD 7 was significantly higher than that of baseline, Sp-1, Sp-2, and end (P < 0.01). Electrogastrography analysis suggests that the frequency of gastric contractions during CS was less than that in the postpartum period.