Canadian Journal of Anaesthesia

, Volume 37, Issue 5, pp 514–520

Propofol infusion anaesthesia for Caesarean section

  • Michael A. Gregory
  • Tony Gin
  • Gordon Yau
  • Raymond K. W. Leung
  • Kelvin Chan
  • Teik E. Oh
Reports of Investigation

Abstract

Two propofol infusion regimens and a standard general anaesthetic were compared in thirty Chinese women undergoing elective Caesarean section. After induction of anaesthesia with propofol 2 mg · kg−1, ten patients received propofol 6 mg · kg−1 · hr−1 and nitrous oxide 50 per cent in oxygen while ten were given propofol 9 mg · kg−1 · hr−1 with 100 per cent oxygen. The other ten patients received thiopentone 4 mg · kg−1 and nitrous oxide 50 per cent in oxygen with enflurane one per cent. Maternal recovery times and psychomotor performance were recorded. Neonates were assessed by Apgar scores, neurologic and adaptive capacity scores (NACS) and umbilical cord blood gas analysis. Haemodynamic changes were similar immediately following induction but the low propofol infusion group had the best haemodynamic stability subsequently. Recovery times were fastest in the low-infusion group but there were no differences in later postbox testing. Neonatal Apgar scores and umbilical blood gas analysis were similar but NACS at two hours were poorer in the high infusion group. A propofol infusion coupled with nitrous oxide appears to be a satisfactory technique for Caesarean section.

Key words

anaesthesia: obstetrical, neonatal assessment anaesthetics, intravenous: propofol anaesthetic techniques: intravenous recovery: assessment 

Résumé

Lors de leur césarienne élective, trente chinoises nous ont permis de comparer deux modes de perfusion de propofol et un autre mode d’anesthésie générate. Après une induction anesthesique avec 2 mg · kg−1 de propofol, nous avons donne à dix d’entre elles 6 mg · kg−1 · h−1 de propofol et 50 pour cent de N2O avec O2 tandis que dix autres recevaient 9 mg · kg−1 · h−1 de propofol et 100 pour cent d’O2. Enfin, nous donnions aux dix dernieres, 4 mg · kg−1 depentothal, 50 pour cent de N2O avec O2 et un pour cent d’enflurane. Nous avons evalue le réveil des meres, leurs performances psychomotrices, les scores d’Apgar, les “Neurologic and Adaptive Capacity Scores” (NACS) des nouveaux-nes et les gaz sanguins du cordon ombilical. Après l’induction, les valeurs hemodynamiques variaient de la même façon mais par la suite, la perfusion de propofol à faible dose assurait une meilleure stabilité. Elle permettait aussi un éveil plus rapide quoique à moyen terme, la recuperation était la meme pour toutes. Quant aux nouveaux-nés, les gaz sanguins et les scores d’Apgar étaient comparables mais le NACS était moins bon, deux heures après la naissance, dans le groupe à haute dose de propofol. line perfusion de propofol couplee à du protoxyde d’azote constitue une technique appropriee à une césarienne.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Michael A. Gregory
    • 1
  • Tony Gin
    • 1
  • Gordon Yau
    • 1
  • Raymond K. W. Leung
    • 2
  • Kelvin Chan
    • 3
  • Teik E. Oh
    • 1
  1. 1.Department of Anaesthesia and Intensive Care, Prince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
  2. 2.Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
  3. 3.Department of PharmacologyThe Chinese University of Hong KongShatinHong Kong
  4. 4.Oldham and District General HospitalOldhamEngland

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