Abstract
Background/aim In this study, it was aimed to investigate the relationship between body mass index (BMI) and cerebral oxygenation during spinal anesthesia in women undergoing cesarean section. This study also aimed to demonstrate whether fetal cord blood oxygenation was affected by maternal BMI and/or delivery time.Materials and methods The study included parturients with ASA I score undergoing cesarean section under spinal anesthesia in 2015 and 2016. They were divided into two groups according to BMI: Group 1 comprised parturients with BMI of <30 (n = 11) and Group 2 comprised parturients with BMI of ≥30 (n = 17). Right cerebral oxygenation (RSO2) and left cerebral oxygenation (LSO2) monitoring was performed using near-infrared spectroscopy (NIRS). The participants were divided into two groups according to the duration of fetal delivery. Group A included parturients with delivery time of <2 min (n = 7) and Group B those with delivery time of >2 min (n = 18), and fetal cord blood oxygenation was measured using a blood gas analyzer.Results Evaluation was made of a total of 25 patients. The RSO2 values were measured at the 20th, 30th, and 35th minutes of the cesarean section procedure and the median values of all the time intervals in Group 1 were significantly lower than those of Group 2 (P < 0.05). The LSO2 value was significantly lower in Group 1 at the 35th minute compared to Group 2 (P < 0.05). The PO2 values of fetal cord blood were significantly lower in Group B (P < 0.05). Conclusion The results of this study showed that parturients with BMI of <30 who are undergoing cesarean section under spinal anesthesia might have an increased risk of complications due to decreased cerebral oxygenation related with hypotension. Therefore, it can be suggested that before and during cesarean section these patients should be closely monitored for cerebral oxygenation using NIRS.
Highlights
Hypotension is a relatively frequent complication of spinal anesthesia in women undergoing cesarean section with incidence ranging from 50% to 80%
The results of this study showed that parturients with body mass index (BMI) of
It can be suggested that before and during cesarean section these patients should be closely monitored for cerebral oxygenation using Near-infrared spectroscopy (NIRS)
Summary
Hypotension is a relatively frequent complication of spinal anesthesia in women undergoing cesarean section with incidence ranging from 50% to 80%. Hypotension during cesarean section is believed to be due to the blockade of regional sympathetic activity [1]. Parturients with hypotension may present with nausea, vomiting, and unconsciousness, and if it persists, pulmonary aspiration may occur. The fetus may be affected, and hypoxia and acidosis may be detected in cord blood [2,3]. To avoid hypotension, various strategies have been attempted, including intravenous fluid administration, prophylactic application of vasoactive drugs, and positioning of the patient [4,5]. Near-infrared spectroscopy (NIRS) is being increasingly used for noninvasive monitoring of cerebral oxygenation in many clinical scenarios [6].
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