Effects of propofol versus thiopental on Apgar scores in newborns and peri-operative outcomes of women undergoing emergency cesarean section: a randomized clinical trial
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
BMC anesthesiology
Abstract
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.
Trial registration: Pan-African Clinical Trial Registry (#PACTR201306000536344) http://www.pactr.org/ATMWeb/
appmanager/atm/atmregistry?_nfpb=true&_pageLabel=atm_portal_page_mytrials
Description
Keywords
Propofol, Thiopental, General anesthesia, Cesarean section, Apgar score
Citation
Tumukunde, J., Lomangisi, D. D., Davidson, O., Kintu, A., Joseph, E., & Kwizera, A. (2015). Effects of propofol versus thiopental on Apgar scores in newborns and peri-operative outcomes of women undergoing emergency cesarean section: a randomized clinical trial. BMC anesthesiology, 15(1), 1-6.DOI 10.1186/s12871-015-0044-6