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. 2014 Nov 29:3:234.
doi: 10.4103/2277-9175.145735. eCollection 2014.

Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study

Somayeh Khanjani  1 , Khosrou Naghibi  2 , Hamed Azarnoush  3
Affiliations

Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study

Somayeh Khanjani et al. Adv Biomed Res. .

Abstract

Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns.

Materials and methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared.

Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values.

Conclusion: According to the patient's state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

Keywords: Apgar score; BIS; Isoflurane; awareness; propofol.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Flow Chart 1
Flow Chart 1
Study flowchart
Figure 1
Figure 1
SQI changes in the two groups
Figure 2
Figure 2
EMG changes in both groups
Figure 3
Figure 3
Changes in the BIS group
Figure 4
Figure 4
Change in systolic blood pressure in both groups
Figure 5
Figure 5
Change in diastolic blood pressure in both groups
Figure 6
Figure 6
Change in mean arterial pressure in both groups
Figure 7
Figure 7
Change in the heart rate in both groups
Figure 8
Figure 8
Median, range, and 25% percentile and 75% extubation time
Figure 9
Figure 9
Median, 25% and 75% percentile range, stay in recovery
See this image and copyright information in PMC

References

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