Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved]
Background: Obesity, abdominal surgery, and intrathecal opioids are all factors associated with a risk for respiratory compromise. The aim of this explorative trial was to study the apnoea/hypopnea index 1st postoperative night in obese mothers having had caesarean section (CS) in spinal anaesthesia...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2018-02-01
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| Series: | F1000Research |
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| Online Access: | https://f1000research.com/articles/6-2062/v2 |
| _version_ | 1818456900408180736 |
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| author | Anette Hein Jan G. Jakobsson |
| author_facet | Anette Hein Jan G. Jakobsson |
| author_sort | Anette Hein |
| collection | DOAJ |
| description | Background: Obesity, abdominal surgery, and intrathecal opioids are all factors associated with a risk for respiratory compromise. The aim of this explorative trial was to study the apnoea/hypopnea index 1st postoperative night in obese mothers having had caesarean section (CS) in spinal anaesthesia with a combination of bupivacaine/morphine and fentanyl. Methods: Consecutive obese (BMI >30 kg/m 2) mothers, ≥18 years, scheduled for CS with bupivacaine/morphine/fentanyl spinal anaesthesia were monitored with a portable polygraphy device Embletta /NOX on 1st postoperative night. The apnoea/hypopnea index (AHI) was identified by clinical algorithm and assessed in accordance to general guidelines; number of apnoea/hypopnea episodes per hour: <5 “normal”, ≥5 and <15 mild sleep apnoea, ≥15 and <30 moderate sleep apnoea, ≥ 30 severe sleep apnoea. Oxygen desaturation events were in similar manner calculated per hour as oxygen desaturation index (ODI). Results: Forty mothers were invited to participate: 27 consented, 23 were included, but polysomnography registration failed in 3. Among the 20 mothers studied: 11 had an AHI <5 (normal), 7 mothers had AHI ≥5 but <15 (mild OSAS) and 2 mothers had AHI ≥15 (moderate OSA), none had an AHI ≥ 30. The ODI was on average 4.4, and eight patients had an ODI >5. Mothers with a high AHI (15.3 and 18.2) did not show high ODI. Mean saturation was 94% (91-96%), and four mothers had mean SpO2 90-94%, none had a mean SpO2 <90%. Conclusion: Respiratory polygraphy 1st night after caesarean section in spinal anaesthesia with morphine in moderately obese mothers showed AHIs that in sleep medicine terms are considered normal, mild and moderate. Obstructive events and episodes of desaturation were commonly not synchronised. Further studies looking at preoperative screening for sleep apnoea in obese mothers are warranted but early postop respiratory polygraphy recording is cumbersome and provided sparse important information. |
| first_indexed | 2024-12-14T22:34:01Z |
| format | Article |
| id | doaj.art-a89d06df632e4f449dd7d91b7f26c569 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-14T22:34:01Z |
| publishDate | 2018-02-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-a89d06df632e4f449dd7d91b7f26c5692022-12-21T22:45:11ZengF1000 Research LtdF1000Research2046-14022018-02-01610.12688/f1000research.13206.215048Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved]Anette Hein0Jan G. Jakobsson1Anaesthesia & Intensive Care, Institution for Clinical Sciences, Karolinska Institutet, Danderyds University Hospital, Stockholm, SwedenAnaesthesia & Intensive Care, Institution for Clinical Sciences, Karolinska Institutet, Danderyds University Hospital, Stockholm, SwedenBackground: Obesity, abdominal surgery, and intrathecal opioids are all factors associated with a risk for respiratory compromise. The aim of this explorative trial was to study the apnoea/hypopnea index 1st postoperative night in obese mothers having had caesarean section (CS) in spinal anaesthesia with a combination of bupivacaine/morphine and fentanyl. Methods: Consecutive obese (BMI >30 kg/m 2) mothers, ≥18 years, scheduled for CS with bupivacaine/morphine/fentanyl spinal anaesthesia were monitored with a portable polygraphy device Embletta /NOX on 1st postoperative night. The apnoea/hypopnea index (AHI) was identified by clinical algorithm and assessed in accordance to general guidelines; number of apnoea/hypopnea episodes per hour: <5 “normal”, ≥5 and <15 mild sleep apnoea, ≥15 and <30 moderate sleep apnoea, ≥ 30 severe sleep apnoea. Oxygen desaturation events were in similar manner calculated per hour as oxygen desaturation index (ODI). Results: Forty mothers were invited to participate: 27 consented, 23 were included, but polysomnography registration failed in 3. Among the 20 mothers studied: 11 had an AHI <5 (normal), 7 mothers had AHI ≥5 but <15 (mild OSAS) and 2 mothers had AHI ≥15 (moderate OSA), none had an AHI ≥ 30. The ODI was on average 4.4, and eight patients had an ODI >5. Mothers with a high AHI (15.3 and 18.2) did not show high ODI. Mean saturation was 94% (91-96%), and four mothers had mean SpO2 90-94%, none had a mean SpO2 <90%. Conclusion: Respiratory polygraphy 1st night after caesarean section in spinal anaesthesia with morphine in moderately obese mothers showed AHIs that in sleep medicine terms are considered normal, mild and moderate. Obstructive events and episodes of desaturation were commonly not synchronised. Further studies looking at preoperative screening for sleep apnoea in obese mothers are warranted but early postop respiratory polygraphy recording is cumbersome and provided sparse important information.https://f1000research.com/articles/6-2062/v2Obstetrical AnesthesiologyRespiratory Problems in Critical Care |
| spellingShingle | Anette Hein Jan G. Jakobsson Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] F1000Research Obstetrical Anesthesiology Respiratory Problems in Critical Care |
| title | Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] |
| title_full | Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] |
| title_fullStr | Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] |
| title_full_unstemmed | Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] |
| title_short | Portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine/morphine/fentanyl spinal anaesthesia [version 2; referees: 2 approved] |
| title_sort | portable respiratory polygraphy monitoring of obese mothers the first night after caesarean section with bupivacaine morphine fentanyl spinal anaesthesia version 2 referees 2 approved |
| topic | Obstetrical Anesthesiology Respiratory Problems in Critical Care |
| url | https://f1000research.com/articles/6-2062/v2 |
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