S Schulzeck1, M Gleim, S Palm. 1. Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany. schulzeck@anaesthesie.uni-kiel.de
Abstract
OBJECTIVE: Regional anaesthesia is recommended for caesarean section in obese women. With regard to this aspect anaesthesia practice in the obstetrics department of the University Hospital Kiel was evaluated retrospectively. METHODS: Data from 1,461 consecutive caesarean sections were evaluated. Pregnant women were subgrouped according to their prepartal body mass index (BMI). Statistics were performed by the chi(2)-test and the Wilcoxon and Mann-Whitney U-test, with a significance threshold of p<0.05. RESULTS: Of the pregnant women who underwent a caesarean section 27% were obese (BMI 30.0-34.9) and 15% were extremely obese (BMI > or =35). Spinal anaesthesia was performed most frequently in 47% with an uptrend in severely obese parturients. All other aspects investigated were independent of BMI. Vasoactive drugs were given less during general anaesthesia than in regional anaesthesia (3 vs. 54%). APGAR values were significantly better with regional anaesthesia, but perioperative complaints of distress were more common. Spinal anaesthesia was favoured by patients and staff in the postoperative survey ( p<0.001). CONCLUSION: Obesity is a common risk factor in caesarean section anaesthesia. Spinal anaesthesia can be recommended even for obese parturients.
OBJECTIVE: Regional anaesthesia is recommended for caesarean section in obesewomen. With regard to this aspect anaesthesia practice in the obstetrics department of the University Hospital Kiel was evaluated retrospectively. METHODS: Data from 1,461 consecutive caesarean sections were evaluated. Pregnant women were subgrouped according to their prepartal body mass index (BMI). Statistics were performed by the chi(2)-test and the Wilcoxon and Mann-Whitney U-test, with a significance threshold of p<0.05. RESULTS: Of the pregnant women who underwent a caesarean section 27% were obese (BMI 30.0-34.9) and 15% were extremely obese (BMI > or =35). Spinal anaesthesia was performed most frequently in 47% with an uptrend in severely obese parturients. All other aspects investigated were independent of BMI. Vasoactive drugs were given less during general anaesthesia than in regional anaesthesia (3 vs. 54%). APGAR values were significantly better with regional anaesthesia, but perioperative complaints of distress were more common. Spinal anaesthesia was favoured by patients and staff in the postoperative survey ( p<0.001). CONCLUSION: Obesity is a common risk factor in caesarean section anaesthesia. Spinal anaesthesia can be recommended even for obese parturients.