Clinical Use of Propofol-Rocuronium for Caesarean Section Anesthesia / 대한마취과학회지

ABSTRACT

BACKGROUND: The effects of propofol-rocuronium on the conditions of tracheal intubation, maternal hemodynamic changes and status of neonates were evaluated in 28 parturients undergoing an elective caesarean section. METHODS: Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.6 mg/kg and maintained with O2-N2O-Propofol. Neuromuscular transmission was assessed using the electromyographic response to the train-of-four stimulation of the ulnar nerve at the wrist every 10 s. Intubation was begun at the disappearance of the T3 of the TOF or 80 s from the administration of rocuronium, whichever occurred first. The conditions for tracheal intubation were classified into four grades as excellent, good, poor and inadequate. The time to the T1 disappearance (onset time) and the time to the reappearance of T2 (duration of the effect) were recorded. The maternal arterial blood pressure and heart rates were measured before and after propofol-rocuronium administration. The neonates were evaluated by the 1-5 min Apgar scores and the acid-base status of the umbilical cord blood. RESULTS: The mean intubation time was 74.4 +/- 10.1 s and the onset time of rocuronium was 100.8 +/- 31.8 s. The intubation conditions were excellent or good in 26 patients (93%) but poor in 2 patients. The maternal arterial blood pressure decreased and the heart rate increased after administering the propofol-rocuronium. The neonatal Apgar scores and blood gas parameters were within the normal range. CONCLUSIONS: Rapid sequence intubation using propofol-rocuronium is clinically acceptable as a caesarean section anesthetic.