[Anesthesia for cesarean section of obese women. Results of a four-year observation].

OBJECTIVE

Regional anaesthesia is recommended for caesarean section in obese women. With regard to this aspect anaesthesia practice in the obstetrics department of the University Hospital Kiel was evaluated retrospectively.

METHODS

Data from 1,461 consecutive caesarean sections were evaluated. Pregnant women were subgrouped according to their prepartal body mass index (BMI). Statistics were performed by the chi(2)-test and the Wilcoxon and Mann-Whitney U-test, with a significance threshold of p<0.05.

RESULTS

Of the pregnant women who underwent a caesarean section 27% were obese (BMI 30.0-34.9) and 15% were extremely obese (BMI > or =35). Spinal anaesthesia was performed most frequently in 47% with an uptrend in severely obese parturients. All other aspects investigated were independent of BMI. Vasoactive drugs were given less during general anaesthesia than in regional anaesthesia (3 vs. 54%). APGAR values were significantly better with regional anaesthesia, but perioperative complaints of distress were more common. Spinal anaesthesia was favoured by patients and staff in the postoperative survey ( p<0.001).

CONCLUSION

Obesity is a common risk factor in caesarean section anaesthesia. Spinal anaesthesia can be recommended even for obese parturients.