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Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study.

Khanjani S, Naghibi K, Azarnoush H - Adv Biomed Res (2014)

Bottom Line: Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared.From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups.Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns.

Materials and methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared.

Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values.

Conclusion: According to the patient's state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

No MeSH data available.


Study flowchart
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Figure 1: Study flowchart

Mentions: Patients were randomly entered into one of the two groups (by random allocation software prepared in a sealed envelope) for receiving isoflurane (manufactured by Piramol Critical Care Inc., USA) and propofol (manufactured by Claris Lifescience Limited, India), by one of the investigators who was not related to data collection, monitoring or conduct of anesthesia. In cases where the patients had a history of seizure or neurological problems, were with the need for sedative drugs, with head trauma requiring hospitalization, surgical procedures, previous brain surgery or addiction, they were not taken into the groups. Also, mothers who suffered from severe changes in hemodynamics (20% higher than the initial condition) during anesthesia or if the dose of the prescribed medications was changed for any reason, they were excluded from the study (one patient was excluded due to profound hypotension, from the Isoflurane group) [Flow Chart 1].


Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study.

Khanjani S, Naghibi K, Azarnoush H - Adv Biomed Res (2014)

Study flowchart
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260274&req=5

Figure 1: Study flowchart
Mentions: Patients were randomly entered into one of the two groups (by random allocation software prepared in a sealed envelope) for receiving isoflurane (manufactured by Piramol Critical Care Inc., USA) and propofol (manufactured by Claris Lifescience Limited, India), by one of the investigators who was not related to data collection, monitoring or conduct of anesthesia. In cases where the patients had a history of seizure or neurological problems, were with the need for sedative drugs, with head trauma requiring hospitalization, surgical procedures, previous brain surgery or addiction, they were not taken into the groups. Also, mothers who suffered from severe changes in hemodynamics (20% higher than the initial condition) during anesthesia or if the dose of the prescribed medications was changed for any reason, they were excluded from the study (one patient was excluded due to profound hypotension, from the Isoflurane group) [Flow Chart 1].

Bottom Line: Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared.From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups.Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns.

Materials and methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared.

Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values.

Conclusion: According to the patient's state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

No MeSH data available.