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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Research article

Effects of propofol versus thiopental on Apgar scores in newborns and peri-operative outcomes of women undergoing emergency cesarean section: a randomized clinical trial

Authors: Janat Tumukunde, Dlamini Diana Lomangisi, Ocen Davidson, Andrew Kintu, Ejoku Joseph, Arthur Kwizera

Published in: BMC Anesthesiology | Issue 1/2015

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Abstract

Background

General and regional anesthesia are the two main techniques used in cesarean section. Regional anesthesia is preferred, but under certain circumstances, such as by patient request and in patients with back deformities, general anesthesia is the only option. Commonly used induction agents include thiopental, ketamine, and propofol, depending on availability and the maternal clinical condition. The objective of this study was to investigate the effects of thiopental and propofol on the neonatal Apgar score and maternal recovery time following emergency cesarean section in order to determine the superior agent for mothers and neonates.

Methods

This single-blinded randomized clinical trial included 150 ASA I and II patients block-randomized equally between the two study arms. Pregnant women at term scheduled to undergo cesarean section and their neonates were enrolled. The primary outcomes were the Apgar scores through 10-min postpartum, resuscitation requirement, and admission to the neonatal intensive care unit. The secondary outcome was the maternal recovery times.

Results

At 0 min (umbilical cord clamp time), 43 (57.3%) neonates in the propofol group had an Apgar score < 7 compared with 31 (41.3%) neonates in the thiopental group (p = 0.05). The maternal recovery time was shorter in the propofol group than in the thiopental group (25 min vs. 31 min, respectively, p = 0.003).

Conclusion

Apgar scores do not differ significantly whether thiopental or propofol is used for anesthetic induction in women undergoing general anesthesia for an emergency cesarean section.
Literature
1.
Jenkins JG, Khan MM. Anaesthesia for Cesarean section: a survey in a UK region from 1992 to 2002. Anaesthesia. 2003;58(11):1114–8.CrossRefPubMed
2.
Barash PG, Cullen Bruce F, Stoelting Robert K, Cahalan Michael K, Stock Christine M. Clinical anaesthesia, USA. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
3.
Ravussin P, Tempelhoff R, Modica PA, Bayer-Berger MM. Propofol vs. Thiopental-Isoflurane for neurosurgical anesthesia: comparison of hemodynamics, CSF pressure, and recovery. J Neurosurg Anesthesiol. 1991;3(2):85–95.CrossRefPubMed
4.
Sanchez-Alcaraz A, Quintana MB, Laguarda M. Placental transfer and neonatal effects of propofol in cesarean section. J Clin Pharm Ther. 1998;23(1):19–23.CrossRefPubMed
5.
Gin T, Gregory MA, Chan K, Oh TE. Maternal and fetal levels of propofol at cesarean section. Anaesth Intensive Care. 1990;18(2):180–4.PubMed
6.
Capogna G, Celleno D, Sebastiani M, Muratori F, Costantino P, Cipriani G, et al. Propofol and thiopentone for cesarean section revisited: maternal effects and neonatal outcome. Int J Obstet Anesth. 1991;1(1):19–23.CrossRefPubMed
7.
Celleno D, Capogna G, Tomassetti M, Costantino P, Di Feo G, Nisini R. Neurobehavioural effects of propofol on the neonate following elective cesarean section. Br J Anaesth. 1989;62(6):649–54.CrossRefPubMed
8.
9.
Hodges SC, Mijumbi C, Okello M, McCormic BA, Walker IA, Wilson IH. Anaesthesia services in developing countries: defining the problems. Anaesthesia. 2007;62(1):4–11.CrossRefPubMed
10.
Valtonen M, Kanto J, Rosenberg P. Comparison of propofol and thiopentone for induction of anaesthesia for elective cesarean section. Anaesthesia. 1989;44(9):758–62.CrossRefPubMed
11.
Fawad Alam WT, Aneel A, Adeel A. Apgar score of Neonate; comparison of thiopentone and propofol during C-section. Professional Med. 2006;13(2):175–7.
12.
Dailland P, Cockshott ID, Lirzin JD, Jacquinot P, Jorrot JC, Devery J, et al. Intravenous propofol during cesarean section: placental transfer, concentrations in breast milk, and neonatal effects. A preliminary study. Anesthesiology. 1989;71(6):827–34.CrossRefPubMed
13.
Gin T, Yau G, Chan K, Gregory MA, Oh TE. Disposition of propofol infusions for cesarean section. Can J Anaesth. 1991;38(1):31–6.CrossRefPubMed
14.
Cockshott ID. Propofol (‘Diprivan’) pharmacokinetics and metabolism–an overview. Postgrad Med J. 1985;61 Suppl 3:45–50.PubMed
15.
Simons PJ, Cockshott ID, Dougla EJ, Gordon EA, Hopkins K, Rowlan M. Disposition in male volunteers of a subanaesthetic intravenous dose of an oil in water emulsion of 14C-propofol. Xenobiotica. 1988;18(4):429–40.CrossRefPubMed
16.
Kay NH, Sear W, Uppington J, Cockshott ID, Douglas EJ. Disposition of propofol in patients undergoing surgery. A comparison in men and women. Br J Anaesth. 1986;58(10):1075–9.CrossRefPubMed
17.
Morgan DJ, Blackman GL, Paull JD, Wolf LJ. Pharmacokinetics and plasma binding of thiopental. II: studies at cesarean section. Anesthesiology. 1981;54(6):474–80.CrossRefPubMed
Metadata
Title
Effects of propofol versus thiopental on Apgar scores in newborns and peri-operative outcomes of women undergoing emergency cesarean section: a randomized clinical trial
Authors
Janat Tumukunde
Dlamini Diana Lomangisi
Ocen Davidson
Andrew Kintu
Ejoku Joseph
Arthur Kwizera
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-015-0044-6

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