Tumukunde Janat, Lomangisi Dlamini Diana, Davidson Ocen, Kintu Andrew, Joseph Ejoku, Kwizera Arthur
Department of Anesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
BMC Anesthesiol. 2015 Apr 29;15:63. doi: 10.1186/s12871-015-0044-6.
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.
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.
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).
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.
Pan-African Clinical Trial Registry (#PACTR201306000536344) http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_pageLabel=atm_portal_page_mytrials.
全身麻醉和区域麻醉是剖宫产术中使用的两种主要技术。区域麻醉是首选，但在某些情况下，如患者要求或存在脊柱畸形的患者，全身麻醉是唯一选择。常用的诱导药物包括硫喷妥钠、氯胺酮和丙泊酚，具体取决于药物可用性和产妇临床状况。本研究的目的是调查硫喷妥钠和丙泊酚对急诊剖宫产术后新生儿阿氏评分和产妇恢复时间的影响，以确定对母亲和新生儿更优的药物。
这项单盲随机临床试验纳入了150例ASA I级和II级患者，将其等比例随机分入两个研究组。纳入计划行剖宫产术的足月孕妇及其新生儿。主要结局指标为产后10分钟内的阿氏评分、复苏需求以及入住新生儿重症监护病房情况。次要结局指标为产妇恢复时间。
在0分钟（脐带夹闭时间）时，丙泊酚组43例（57.3%）新生儿阿氏评分<7分，硫喷妥钠组为31例（41.3%）（p = 0.05）。丙泊酚组产妇恢复时间短于硫喷妥钠组（分别为25分钟和31分钟，p = 0.003）。
在急诊剖宫产全身麻醉中，使用硫喷妥钠或丙泊酚进行麻醉诱导时，阿氏评分无显著差异。
泛非临床试验注册中心（#PACTR201306000536344）http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_pageLabel=atm_portal_page_mytrials
