Sánchez-Romero Javier, López-Pérez Jesús, Flores-Muñoz Ana Belén, Méndez-Martínez María Josefa, Araico-Rodríguez Fernando, Mendiola-Olivares Jaime, Blanco-Carnero José Eliseo, Falcón-Araña Luis, Nieto-Díaz Aníbal, Sánchez-Ferrer María Luisa
Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Hospital, 30120 Murcia, Spain.
Department of Obstetrics and Gynecology, The University of Murcia, 30011 Murcia, Spain.
J Clin Med. 2022 Jan 19;11(3):489. doi: 10.3390/jcm11030489.
Although the influence of neuraxial anesthesia or sedation with remifentanil in external cephalic version (ECV) is widely known, ECV results using propofol have not been previously analyzed. This study aimed to evaluate ECV outcomes when propofol was used. An observational analysis of ECV was performed between 1 January 2018 and 31 December 2020. ECV was accomplished with tocolysis and propofol. One hundred and thirty-one pregnant women were recruited. The propofol mean dose was 156.1 mg (SD 6.1). A cephalic presentation was achieved in 61.1% (80/131) of the pregnant women. In total, 56.7% (38/67) of pregnant women with cephalic presentation at labor had a spontaneous delivery, 26.9% (18/67) had an operative delivery, and an intrapartum urgent cesarean section was performed in 16.4% (11/67). In total, 46 pregnant women (35.9%) were scheduled for an elective cesarean section due to non-cephalic presentation. The emergency cesarean section rate during the following 24 h was 10.7% (14/131). A major ECV complication arose in 15 cases (11.5%). ECV outcomes when propofol was used seems to be similar to those with other anesthetic adjunct, so sedation with propofol could be an adequate option for ECV. More studies are needed to compare its effectiveness with neuraxial techniques.
尽管椎管内麻醉或瑞芬太尼镇静对外转胎位术（ECV）的影响广为人知，但此前尚未分析过使用丙泊酚进行ECV的结果。本研究旨在评估使用丙泊酚时的ECV结局。对2018年1月1日至2020年12月31日期间的ECV进行了观察性分析。ECV在使用宫缩抑制剂和丙泊酚的情况下完成。招募了131名孕妇。丙泊酚的平均剂量为156.1mg（标准差6.1）。61.1%（80/131）的孕妇实现了头先露。总共，67名头先露的孕妇中，56.7%（38/67）自然分娩，26.9%（18/67）接受了手术分娩，16.4%（11/67）进行了产时紧急剖宫产。总共46名孕妇（35.9%）因非头先露而计划择期剖宫产。接下来24小时内的紧急剖宫产率为10.7%（14/131）。15例（11.5%）出现了严重的ECV并发症。使用丙泊酚时的ECV结局似乎与使用其他麻醉辅助药物时相似，因此丙泊酚镇静可能是ECV的一个合适选择。需要更多研究来比较其与椎管内技术的有效性。
