Evaluation of Capnography with Spontaneous Respiration under Regional Anaesthesia in LSCS Patients and its Clinical Application - A Prospective Observational Study

Dr. Swaminathan T N, Dr. Sarojini Bobde

Abstract: Background: Pregnant women may experience potentially fatal conditions before, during, and after giving birth. Capnography is the continuous monitoring of instantaneous CO2 concentration in expired gases during respiratory cycle. Routinely ETCO2 monitoring is done in intubated patients. Patients who undergo LSCS under regional anaesthesia carrying same obstetric risk do not get advantage of capnography monitoring as standard of care. This study aims to correlate the trends of capnography in LSCS patients under Regional anaesthesia. Methodology: It was a prospective observational cohort study done at tertiary care hospital. Total 241female patients undergoing LSCS surgery under regional anaesthesia were included in the study. After spinal anaesthesia ETCO2 monitoring was done at various steps of LSCS along with other vital parameters. Result: The average age of the parturient was 26.00 ? 3.94 years, ranging from 20-32 years. The mean end-tidal CO2 (ETCO2) level at the time of incision was 33.17 mmHg, with a range from 24 to 35 mmHg. Across all stages of LSCS, patients with a higher ASA grade (ASA III) exhibited lower mean ETCO2 levels compared to those with a lower ASA grade (ASA II). Mean ETCO2 was significantly lower in ASA III patients. Conclusion: The study successfully demonstrated that capnography can be used in non intubated obstetric patients under central neuraxial blockade. Significant fluctuation in ETCO2 levels were observed throughout the different steps of LSCS with significant fall in ETCO2 observed during Placental delivery

Keywords: capnography, LSCS, spontaneous respiration, regional anaesthesia