Obstetric Anesthesia

Anesthesia for Cesarean Delivery

The effect of labor on sevoflurane requirements during cesarean delivery

Erden V, Erkalp K, Yangin Z, et al (Vakif Gureba Educational Hosp, İstanbul, Turkey) Int J Obstet Anesth 20:17-21, 2011^§

Abstract

Background

Labor results in the release of sensitizing substances such as progesterone, prostaglandins, cytokines and cortisol, some of which have been observed to participate in sleep regulation. We hypothesized that these substances could affect sleep regulation and therefore the amount of volatile agent required to provide general anesthesia for cesarean delivery.

Methods

A total of 50 patients were enrolled, of whom 25 had uterine activity less than 30 Montevideo units (Prelabor group) and 25 had uterine activity greater than 80 Montevideo units (Labor group). Anesthesia was maintained with 50% oxygen in nitrous oxide with sevoflurane. Sevoflurane concentration was adjusted to sustain a constant Bispectral Index (BIS) value of 40–55. Prolactin, progesterone and cortisol levels were evaluated immediately before cesarean delivery.

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