Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery - 07/08/11
: Instructor, Brendan Carvalho, FRCA a : Assistant Professor, Christina Danial b : Medical Student, Edward Riley, MD a : Associate ProfessorAbstract |
Study Objective |
To examine the relationship between body mass index (BMI), perioperative times, and anesthetic interventions in patients undergoing elective cesarean delivery.
Design |
Retrospective chart review.
Setting |
University-affiliated hospital.
Measurements |
All patients were ranked according to BMI (kg/m2) at the time of delivery. The BMI groups were designated a priori: ≤ 29.9 kg/m2 (Group C); 30-34.9 kg/m2 (Group I); 35-39.9 kg/m2 (Group II), and ≥ 40 kg/m2 (Group III). One hundred patients (25 pts per group) underwent elective cesarean delivery. Data collected included anesthetic technique, perioperative times, anesthesia-related costs, and neonatal outcomes.
Main Results |
A higher percentage of Group III patients (60%) received combined spinal-epidural (CSE) anesthesia than did Group C or Group I (18% and 16%, respectively; P < 0.05). The total intraoperative period was significantly longer in Group III (101 min) compared with Groups C, I, and II (81 min, 90 min, and 92 min, respectively; P < 0.05). Total intraoperative time increased significantly with BMI (R = 0.394 kg/m2; P < 0.001). The highest anesthesia-related costs during the study were generated by patients with BMI ≥ 40 kg/m2.
Conclusion |
Our single-center experience showed that choice of anesthetic technique (CSE vs. spinal anesthesia) varies according to obesity class. Longer intraoperative periods must be considered in deciding upon the mode of anesthesia for patients with BMI ≥ 40 kg/m2 who undergo elective cesarean delivery.
Le texte complet de cet article est disponible en PDF.Keywords : Cesarean section, Obesity, Obstetric anesthesia
Plan
| ☆ | This study was conducted at Lucile Packard Children’s Hospital and Stanford University School of Medicine, Stanford, CA. |
| ☆☆ | Presented in part at the 40th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP), April 2008, Chicago, IL, USA. |
| ★ | Funded internally by the Department of Anesthesia, Stanford University Medical Center. The authors involved in this study and the preparation of the manuscript received no external funding. |
| ★★ | The authors had no affiliation or relationship with any company or organization that has a potential interest in the outcome of the study. |
Vol 22 - N° 7
P. 519-526 - novembre 2010 Retour au numéro
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