Dataset Information

Anesthetic management of patients with class 3 obesity undergoing elective Cesarean delivery: a single-centre historical cohort study.

ABSTRACT:

Purpose

The preferred neuraxial anesthetic technique for patients with class 3 obesity undergoing elective Cesarean delivery is still under debate. We aimed to describe the anesthetic technique used in our tertiary institution across body mass index (BMI) groups and different surgical incisions.

Method

In this historical cohort study, we reviewed medical records of patients with a BMI ≥ 40 kg·m^-2 undergoing elective Cesarean delivery between July 2014 and December 2020. We collected data on patient characteristics, anesthetic and surgical technique, and procedural times. For data analysis, we stratified patients by BMI into three different groups: 40.0-49.9 kg·m^-2, 50.0-59.9 kg·m^-2, and ≥ 60.0 kg·m^-2.

Results

We included 396 deliveries, distributed as follows: 258 with a BMI 40.0-49.9 kg·m^-2, 112 with a BMI 50.0-59.9 kg·m^-2, and 26 with a BMI ≥ 60.0 kg·m^-2. For patients with a BMI 40.0-49.9 kg·m^-2, the anesthetic technique of first choice was predominantly spinal anesthesia (71%), whereas for those with a BMI ≥ 60.0 kg·m^-2, spinal anesthesia was never used as the anesthetic of first choice. With regard to the surgical incision, spinal anesthesia was almost exclusively used for patients undergoing Pfannenstiel incision and was rarely used for a higher supra- or infraumbilical transverse or midline incision. The overall incidence of general anesthesia was low (7/396, 1.8%). Anesthetic time, surgical time, and operating room time increased almost twofold in patients with a BMI ≥ 60.0 kg·m^-2 compared with those with a BMI of 40.0-49.9 kg·m^-2.

Conclusion

Neuraxial anesthesia was successfully used in approximately 98% of patients with class 3 obesity undergoing elective Cesarean delivery. The choice of regional anesthesia technique varied with increasing BMI and with the planned surgical incision. Procedural times increased with increasing BMI. This information should prove useful for comparing anesthetic choices and outcomes in this challenging population.

SUBMITTER: van den Bosch OFC

PROVIDER: S-EPMC9957904 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Anesthetic management of patients with class 3 obesity undergoing elective Cesarean delivery: a single-centre historical cohort study.

van den Bosch Oscar F C OFC Fiset Marie-Eve ME Downey Kristi K Maxwell Cynthia C Carvalho Jose C A JCA

Canadian journal of anaesthesia = Journal canadien d'anesthesie 20221129 2

<h4>Purpose</h4>The preferred neuraxial anesthetic technique for patients with class 3 obesity undergoing elective Cesarean delivery is still under debate. We aimed to describe the anesthetic technique used in our tertiary institution across body mass index (BMI) groups and different surgical incisions.<h4>Method</h4>In this historical cohort study, we reviewed medical records of patients with a BMI ≥ 40 kg·m<sup>-2</sup> undergoing elective Cesarean delivery between July 2014 and December 2020. ...[more]

PMID: 36447090

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Dataset Information

Anesthetic management of patients with class 3 obesity undergoing elective Cesarean delivery: a single-centre historical cohort study.

Purpose

Method

Results

Conclusion

Publications

Anesthetic management of patients with class 3 obesity undergoing elective Cesarean delivery: a single-centre historical cohort study.

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