Comparison of thiopentone and diazepam as induction agents of anaesthesia for Caesarean section

Abstract

Clinical effects of thiopentone (3 mg/kg body weight) and diazepam (0.3 mg/kg) were compared for elective caesarean sections in two groups of 43 and 39 women, respectively. They were given general anaesthesia in left lateral tilt. The systolic, diastolic and mean arterial pressures were moderately elevated at onset of surgery in both groups, probably indicating light anaesthesia. Later, a gradual decrease to the preinduction levels was observed. The mean injection-delivery (I-D) interval was 344 s in the thiopentone group and 339 s in the diazepam group. The I-D intervals were shorter than 10 min in 39 of the cases in the thiopentone group and 38 cases in the diazepam group. Low Apgar scores at 1 min (6 or less) occurred in five of the neonates in each group, while all had normal Apgar scores at 5 min ( 7 or mor) As judged by the Apgar scores and the acid-base status of umbilical cord blood, the effects of the induction agents on the neonatal condition were indistinguishable in the two groups. In the thiopentone group, unpleasant recollections were reported in 5 out of 40 patients (12.5%) compared to none in the diazepam group. Diazepam-nitrous oxide anaesthesia is well accepted by the mothers and is alternative to supplementing thiopentone induction with a volatile gas for patients who have previous experienced wakefulness or express fear of awareness. The main drawback with diazepam induction, however, is the slow induction of sleep. Harmful drug effects on the neonates must be expected if the dose has to be increased in order to ensure sleep.