Korean J Anesthesiol.  1987 Dec;20(6):774-781. 10.4097/kjae.1987.20.6.774.

Blood Gas Changes in the Paturient and Fetus under General Anesthesia for Cesarean Section

• Yoo DW
• Lee CH

• KMID: 2090495
• DOI: http://doi.org/10.4097/kjae.1987.20.6.774

Abstract

Anesthesia for Cesarean Section entails many considerations not pertinent to surgical patients. The anesthesiologist is required to provide anesthesia for mother and fetus simultaneously and to perform emergency anesthesia in high risk paturients with no preoperative evaluation. Variable phrsiologic changes in pregnancy in the cardiovascular, respiratory, gastro-intestinal and renal systems entrance the uptake of anesthetic gases and in the apneic status, PaO2 decreases significantly. During general anesthesia, maternal hypoxia, hyperventilation, aortocaval compression of the enlarged uterus and prolonged induction-delivery time may contribute to circulatory changes which may result in fetal hypoxia and acidosis Kalapa et at (1971) and Gibbs (1981) reported that balanced anesthesia is safe for Cesarean section as long as the time from induction to delivery (IDT) is not prolonged. Maternal arterial blood gases after induction and delivery and fetal umbilical arterial and venous blood gases were measured in 30 paturients under going Cesarean section with thiopental-SCC-N2O-O2 anesthesia (general balanced anesthesia). The relationship between IDT and the apgar score was also studied. The results were as follows : 1) Analysis of tole Paturients arterial blood gases after induction arid after delivery, had no statistical significance. 2) Blood gas analysis from the umbilical of the fetus was pH 7.36 +/- 7.04, PCO2 39.8 +/-3.7 torr, PO2 36.8+/-3.4 torr, BE -2.8+/-0.7 mEq/l and oxygen saturation was 72.2+/-5.8%. Umbilical arterial blood from the fetus was 7.31+/-0.03, PCO2 49.1+/-4.8 torr, PO2 25.9+/-4.7 torr, BE -2.6+/-0.6 mEq/I and oxygen saturation was 36.2+/-3.4%. 3) The results of blood gas tension and acid-base status of the paturient according to IDT were not Statistically Significant in any group- 4) The results of' the apgar score according to IDT indicated that the 1 minute apgar score was statistically singinificant but not clinically the 5 minute appear score was not statistically significant.

MeSH Terms

Acidosis
Anesthesia
Anesthesia, General*
Anesthetics, Inhalation
Anoxia
Apgar Score
Balanced Anesthesia
Blood Gas Analysis
Cesarean Section*
Emergencies
Female
Fetal Hypoxia
Fetus*
Gases
Humans
Hydrogen-Ion Concentration
Hyperventilation
Mothers
Oxygen
Pregnancy
Uterus
Anesthetics, Inhalation
Gases
Oxygen