Randomized, double-blind comparison of different inspired oxygen fractions during general anaesthesia for Caesarean section †

Kee, Warwick D. Ngan; Khaw, Kim S.; Ma, Ken; Wong, April S. Y.; Lee, B.B.

doi:10.1093/bja/aef203

Cited by 40 publications

(15 citation statements)

References 16 publications

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“…Maternal hyperoxia is known to increase fetal oxygen supply provided there is normal placental function. This has been demonstrated in the human fetus by cordocentesis, pulse oximetry and postpartum umbilical cord blood sampling. Furthermore, using the BOLD MRI technique in the sheep fetus we have demonstrated that maternal hyperoxia increases fetal tissue oxygenation in a number of fetal organs.…”

Section: Discussionmentioning

confidence: 74%

Changes in human placental oxygenation during maternal hyperoxia estimated by blood oxygen level‐dependent magnetic resonance imaging (BOLD MRI)

Sørensen

Peters

Fründ

et al. 2013

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 74%

Changes in human placental oxygenation during maternal hyperoxia estimated by blood oxygen level‐dependent magnetic resonance imaging (BOLD MRI)

Sørensen

Peters

Fründ

et al. 2013

Ultrasound in Obstet & Gyne

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“…What is the evidence that it is appropriate to provide oxygen even though the mother is not hypoxemic? [7] As for the neonatal aspect, maternal use of inspired oxygen fractions <0.5 did not cause any change in the partial pressure of oxygen in the umbilical vein [2, 8]. Therefore, we conducted a prospective, randomized, controlled trial to determine the benefits of routinely administering supplemental, low-dose oxygen to uncomplicated parturients undergoing elective cesarean section under spinal anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Effects of Supplemental Oxygen on Maternal and Neonatal Oxygenation in Elective Cesarean Section under Spinal Anesthesia: A Randomized Controlled Trial

Siriussawakul

Triyasunant

Nimmannit

et al. 2014

BioMed Research International

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The use of supplemental oxygen in uncomplicated cesarean deliveries under spinal anesthesia has been thoroughly investigated during recent decades. The aim of this study was to determine the benefits for both mother and infant of administering supplemental, low-dose oxygen via a nasal cannula versus having no supplement (i.e., room air only). Healthy parturients at term undergoing elective cesarean section under spinal anesthesia were randomly allocated into two groups: an oxygen group (n = 170), who received 3 LPM oxygen via a nasal cannula; and a room-air group (n = 170), who were assigned to breathe room air. Maternal oxygen saturation was measured continuously by using pulse oximeter. The desaturation was determined by oxygen saturation <94% over 30 seconds. Umbilical cord gases and Apgar scores were collected followed delivery of the infant. All maternal desaturation events occurred in 12 parturients assigned to the room-air group. Most events were concurrent with hypotension. The umbilical venous partial pressure of oxygen was significantly higher in the oxygen group. The other blood gas measurements and Apgar scores were not significantly different between the two groups. Based on our findings, the use of supplemental oxygen could prevent maternal desaturation resulting from receiving sedation and intraoperative hypotension.

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“…Of these 12 studies, six did not include an intervention or comparator relevant to this review , in five studies the depth of anaesthesia differed between study arms [ and two papers reported on the ENIGMA‐2 study , which did not measure AAGA. Through this process we identified 22 publications covering 15 RCTs for inclusion in the review .…”

Section: Resultsmentioning

confidence: 99%

“…One study , although included in the qualitative synthesis of this review, could not be included in the primary analysis as the number of participants in each group was not reported. Eleven studies included a single comparison of a study group with nitrous oxide and a group without nitrous oxide , whereas four studies included more than one comparison . These ‘multi‐arm’ studies, included four or three comparison groups.…”

Section: Resultsmentioning

confidence: 99%

Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review

et al. 2017

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Summary Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is ‘explicit’ if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events. The awareness incidence rate was rare within these studies, and all were considered underpowered with respect to this outcome. The risk of bias across all studies was judged to be high, and 76% of studies failed adequately to conceal participant allocation. We considered the available evidence to be of very poor quality. There were a total of three accidental awareness events reported in two studies, one of which reported that the awareness was the result of a kink in a propofol intravenous line. There were insufficient data to conduct a meta‐ or sub‐group analysis and there was insufficient evidence to draw outcome‐related conclusions. We can, however, recommend that future studies focus on potentially high‐risk groups such as obstetric or cardiac surgery patients, or those receiving neuromuscular blocking drugs or total intravenous anaesthesia.

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Randomized, double-blind comparison of different inspired oxygen fractions during general anaesthesia for Caesarean section †

Abstract: Use of FI(O(2)) 1.0 during general anaesthesia for elective Caesarean section increased fetal oxygenation.

Cited by 40 publications

References 16 publications

Changes in human placental oxygenation during maternal hyperoxia estimated by blood oxygen level‐dependent magnetic resonance imaging (BOLD MRI)

Changes in human placental oxygenation during maternal hyperoxia estimated by blood oxygen level‐dependent magnetic resonance imaging (BOLD MRI)

Effects of Supplemental Oxygen on Maternal and Neonatal Oxygenation in Elective Cesarean Section under Spinal Anesthesia: A Randomized Controlled Trial

Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review

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