The Application of Total Intravenous Anesthesia & Propofol-N2O Anesthesia for Cesarean Section / 대한마취과학회지

ABSTRACT

BACKGROUND: According to the increasing rate of cesarean section, the efforts of seeking safer and more satisfactory obstetric anesthesia techniques have been continued. Propofol, 2,6 di-isopropyl phenol, is a relatively new intravenous anesthetic agent and has been used for induction and maintenance for total intravenous anesthesia (TIVA). Authors examined the anesthetic technique using following anesthetics combinations; N2O-propofol, fentanyl-propofol, ketamine-propofol and made comparison of these ones for intraoperative hemodynamic stability, maternal and fetal safety. METHODS: Sixty patients (ASA physical status 1 or 2) scheduled for cesarean section were randomly allocated into three groups, group N (propofol-N2O, n=20), group F (propofol-fentanyl, n=20), group K (propofol-ketamine, n=20). We checked the changes of blood pressure and heart rates during operation, anesthetic induction time, neonatal status (Apgar score, umbilical vein blood gas analysis), presence of intraoperative awareness and recovery time. RESULTS: No significant differences in intraoperative hemodynamic changes, induction time and baby status. Total propofol dosages were greater in group N than group K (p<0.05) and maternal recovery time was prolonged in group K than group N or F (p<0.05). CONCLUSIONS: Anesthetic management using propofol-N2O or propofol-fentanyl or propofol-ketamine for cesarean section would provide satisfactory anesthesia without significant adverse effects to both mother and fetus.