Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942009000400007
Brazilian Journal of Anesthesiology
Scientific Article

Correlação entre a fração inspirada de oxigênio, a pressão parcial de oxigênio materno e a pressão parcial de oxigênio fetal durante parto cesáreo em gestações normais

Correlation between the inspired fraction of oxygen, maternal partial oxygen pressure, and fetal partial oxygen pressure during cesarean section of normal pregnancies

Carlos Henrique Viana de Castro; Marcos Guilherme Cunha Cruvinel; Fabiano Soares Carneiro; Yerkes Pereira Silva; Antônio Carlos Vieira Cabral; Roberto Cardoso Bessa

http://dx.doi.org/10.1590/S0034-70942009000400007 Braz J Anesthesiol, vol.59, n4, p.452-460, 2009
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Resumo

JUSTIFICATIVA E OBJETIVOS: Apesar das alterações na função pulmonar, a oxigenação materna se mantém nas anestesias regionais para obstetrícia. Mesmo assim, nessas situações, o fornecimento de oxigênio suplementar para a mãe é prática disseminada. A principal justificativa é a boa oxigenação fetal; entretanto, não há devida comprovação. Este estudo prospectivo e com distribuição randômica das pacientes teve o objetivo de testar a hipótese da existência ou não de correlação entre hiperóxia materna e elevação de parâmetros gasométricos fetais na cesariana eletiva. MÉTODO: Foram estudadas vinte pacientes grávidas, submetidas à raquianestesia, através de gasometrias arteriais, com diferentes frações inspiradas de oxigênio e correlacionadas com a gasometria fetal. RESULTADOS: O aumento da fração inspirada de oxigênio materno não se correlacionou com o aumento da pressão parcial de oxigênio fetal. CONCLUSÕES: A indução de hiperóxia materna através de oxigenoterapia suplementar não foi capaz de aumentar a pressão parcial de oxigênio no feto. Não houve modificação nos parâmetros gasométricos fetais, mesmo em caso de mudança desses parâmetros na parturiente, induzidos pela hiperóxia durante a cesariana sob raquianestesia.

Palavras-chave

CIRURGIA, Obstétrica, FISIOLOGIA, FISIOLOGIA

Abstract

BACKGROUND AND OBJECTIVES: Despite changes in pulmonary function, maternal oxygenation is maintained during obstetric regional blocks. But in those situations, the administration of supplementary oxygen to parturients is a common practice. Good fetal oxygenation is the main justification; however, this has not been proven. The objective of this randomized, prospective study was to test the hypothesis of whether maternal hyperoxia is correlated with an increase in fetal gasometric parameters in elective cesarean sections. METHODS: Arterial blood gases of 20 parturients undergoing spinal block with different inspired fractions of oxygen were evaluated and correlated with fetal arterial blood gases. RESULTS: An increase in maternal inspired fraction of oxygen did not show any correlation with an increase of fetal partial oxygen pressure. CONCLUSIONS: Induction of maternal hyperoxia by the administration of supplementary oxygen did not increase fetal partial oxygen pressure. Fetal gasometric parameters did not change even when maternal parameters changed, induced by hyperoxia, during cesarean section under spinal block.

Keywords

PHYSIOLOGY, PHYSIOLOGY, SURGERY, Obstetric

References

Nunn JF. Elastic Forces and Lung Volumes. Nunn's Applied Respiratory Physiology. 1993:53-68.

Steinbrook RA. Respiratory effects of spinal anesthesia. Int Anesthesiol Clin. 1989;27:40-45.

Pitkanen MT. Body mass and spread of spinal anesthesia with bupivacaine. Anesth Analg. 1987;66:127-131.

Gogarten W. Spinal anaesthesia for obstetric. Best Pract Res Clin Anaesthesiol. 2003;17:377-392.

Kelly MC, Fitzpatrick KT, Hill DA. Respiratory effects of spinal anaesthesia for cesarian section. Anaesthesia. 1996;51:1120-1122.

Crawford JS. Principles and Practice of Obstetric Edinburg (UK): Anaesthesia. 1984.

Stone AG, Howell PR. Use of the common gas outlet for the administration of supplemental oxygen during Caesarean section under regional anaesthesia. Anaesthesia. 2002;57:690-692.

Marx GF, Mateo CV. Effects of different oxygen concentrations during general anaesthesia for elective caesarian section. Can Anaesth Soc J. 1971;18:587-593.

Ramanathan S, Gandhi S, Arismendy J. Oxygen transfer from mother to fetus during cesarian section under epidural anesthesia. Anesth Analg. 1982;61:576-581.

Khaw KS, Wang CC, Ngan Kee WD. Effects of high inspired oxygen fraction during elective caesarean section under spinal anaesthesia on maternal and fetal oxygenation and lipid-peroxidation. Br J Anaesth. 2002;88:18-23.

Saugstad OD, Rootwelt T, Aalen O. Resuscitation of asphyxiated newborn infants with room air or oxygen: an international controlled trial: the Resair 2 study. Pediatrics. 1998;102:e1.

Saugstad OD, Ramji S, Vento M. Resuscitation of depressed newborn infants with ambient air or pure oxygen: a meta-analysis. Biol Neonate. 2005;87:27-34.

Cogliano MS, Graham AC, Clark VA. Supplementary oxygen administration for elective Caesaeran section under spinal anaesthesia. Anaesthesia. 2002;57:66-69.

Schaaps JP, Tsatsaris V, Goffin F. Shunting the intervillous space: new concepts in human uteroplacental vascularization. Am J Obstet Gynecol. 2005;192:323-332.

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