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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.


SQI changes in the two groups
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Figure 2: SQI changes in the two groups

Mentions: In Table 2, the mean and standard deviation of the SQI, EMG, and BIS indices have been shown. According to the table, changes of all the three above-mentioned variables are balanced from the fifth to the sixtieth minute, in both groups. Conducting the ANOVA test, with repeated observations also showed that the mean of the changes in SQI, EMG, and BIS had no significant differences in the two groups receiving propofol and isoflurane (P > 0.05). The process of changes in the three mentioned variables has been shown in Figures 1–3, in both groups, from the fifth to the sixtieth minute.


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)

SQI changes in the two groups
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: SQI changes in the two groups
Mentions: In Table 2, the mean and standard deviation of the SQI, EMG, and BIS indices have been shown. According to the table, changes of all the three above-mentioned variables are balanced from the fifth to the sixtieth minute, in both groups. Conducting the ANOVA test, with repeated observations also showed that the mean of the changes in SQI, EMG, and BIS had no significant differences in the two groups receiving propofol and isoflurane (P > 0.05). The process of changes in the three mentioned variables has been shown in Figures 1–3, in both groups, from the fifth to the sixtieth minute.

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.