Maternal and Neonatal Effects of Thiopentone and Propofol as Induction Agents for Cesarean Section

Kim, Jong Hak; Kim, Chi Hyo; Lee, Choon Hi; Sur, Eun Hee

Abstract

Thiopentone was compared with propofol as an induction agent of anesthesia in 30 women in ASA class I or II undergoing elective or emergency cesarean section. Patients were randomly assigned to either thiopentone(n=15) or propofol(n=15) group. Anesthesia was induced with an IV bolus of thiopental sodium(4mg/Kg) or propofol (2mg/Kg), and maintained with 50% nitrous oxide in oxygen supplemented with enflurane for both groups. The systolic and diastolic blood pressure, heart rate, induction-to-delivery time(IDT), uterine incision-to-delivery time(UDT), Apgar score at 1 and 5 minutes, maternal arterial, umbilical arterial and venous blood gas analyses, degree of uterine contraction, pre-operative and postoperative hemoglobin and hematocrit were measured. The results were as follows ; 1) The hemodynamic response to thiopentone and propofol were similar, but increase in maternal systolic blood pressure and heart rate were less in the propofol group than in the thiopentone group immediately after intubation. 2) The mean IDT was longer in the propofol group compared with thiopentone group, but the average UDT was similar. The average Apgar score at 1 and 5 minutes were no significantly different between the induction agents. 3) The mean maternal arterial, umbilical venous & arterial blood gas analyses at delivery were within the normal range and comparable for the two groups. 4) No significant difference in the degree of uterine contraction and decrease in the hemoglobin and hematocrit levels 72 hour after cesarean section was noted between the two groups.In conclusion, propofol was found to be similar to thiopentone in the effects on the moth- er and neonate. Therefore propofol appears to be a suitable alternative to thiopentone as an induction agent for anesthesia in cesarean section, if, sufficient precaution about hemody- namic changes after induction should be considered.