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CLINICAL TRIAL
COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
Standard preoxygenation technique versus two rapid techniques in pregnant patients.
International Journal of Obstetric Anesthesia 2004 January
The aim of this study was to compare three different preoxygenation techniques in pregnant women by measuring end-tidal fractional oxygen concentration (FETO2): the traditional technique of 3min tidal volume breathing (VT x 3 min), 8 deep breaths (8 DB) and 4 deep breaths (4 DB). Twenty pregnant volunteers without pulmonary diseases were studied during the third trimester (36-38 weeks' gestation). Women were preoxygentated using a non-rebreathing respiratory circuit with a 3-L reservoir bag and a Capnomac Ultima calibrated before each patient to monitor FETO2 continuously. The three preoxygenation techniques were investigated in random order: VT x 3 min using an oxygen flow of 9 L min-1, 4 DB within 30s using an oxygen flow of 9 L min-1, and 8 DB within one minute using an oxygen flow of 15 L min-1. Between each technique, 5-min room air breathing was allowed to return to baseline FETO2 assessed by the Capnomac Ultima. An FETO2 >/= 90% was achieved more frequently with the VT x 3 min and the 8 DB techniques (76%) than with the 4 DB technique (18%) (P < 0.05). The average time required for obtaining an FETO2 >/= 90% was 107+/-37s. Both the VT x 3 min and the 8 DB techniques are therefore more effective for preoxygenation in pregnant patients than the 4 DB technique. In an acute obstetric emergency before rapid-sequence induction of general anaesthesia, 8 DB preoxygenation technique could be recommended.
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