The Effects of Sedation Using Propofol TCI on the Satisfaction Level and Side Effects of Parturients during Regional Anesthesia for a Cesarean Section

Ahn, Hyun Joo; Kim, Young Ah; Choi, Duck Hwan

Abstract

BACKGROUND: Regional anesthesia is widely used for a cesarean section. However, the awake state during a cesarean section could be a horrible experience for mothers and adverse effects such as nausea, vomiting, abdominal discomfort, pruritus and shivering are common complications of regional anesthesia. Therefore, we administered propofol that has sedative and antiemetic effects using target controlled infusion (TCI) and evaluated optimal predicted propofol concentrations that have maximal satisfaction with minimal side effects.
METHODS
One hundred twenty parturients scheduled for an elective cesarean section were randomly allocated into one of four groups (control, Gr 1ng/ml, Gr 1.5ng/ml, and Gr 2ng/ml). A combined spinal epidural procedure was performed. After the baby's delivery, propofol TCI of a predetermined concentration (0, 1, 1.5, or 2ng/ml) was administered to the end of operation. Sedation scores (1 - 6, 1: full awake, 6: unresponsive to firm facial tap), satisfaction scores by VAS system (0 - 100 mm, 0 mm: no satisfaction at all, 100 mm: perfect satisfaction), and side effects (nausea/vomiting, abdominal discomfort, pruritus, shivering, retrograde amnesia, hypotension, desaturation, and excitation) were checked.
RESULTS
Mean sedation scores were increased along with a higher propofol concentration. All TCI groups felt more satisfaction compared to the control group. Incidences of nausea/vomiting, pruritus and abdominal discomfort were higher in the control group. Excitation without cooperation and desaturation (SpO2 < 90%) occurred in 4 and 5 parturients in Gr 2ngg/ml.
CONCLUSIONS
We concluded that sedation using propofol TCI is useful in reducing intraoperative side effects and increasing parturients' satisfaction during regional anesthesia for a cesarean delivery. The appropriate predicted concentration of propofol for this purpose was 1.0 or 1.5ngg/ml.