Comparative Study of Effect of General Anesthesia with Thiopental and Propofol on Apgar Score of Neonate and Uterine Relaxation in Cesarean Section

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor, Department of Biostatistics, Faculty of Public Health, University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Thiopental sodium is vastly used in cesarean section for anesthesia. In cases where Thiopental sodium is contraindicated, an alternative drug which has minimum effects on apgar score and maximum uterus relaxation during fetal departure should be selected. This study is aimed to investigate the effects of anesthesia with Propofol, as an alternative drug, on apgar score and uterus relaxation rate in cesarean section.
Methods: This clinical trial was held on 60 patients who referred to academic hospitals of Mashhad city for cesarean delivery. The subjects were randomly divided into two groups. Propofol 2-2.5mg/kg was administered to one group and thiopental sodium 5mg/kg was administered to other group. Parameters such as vital signs before and after induction, apgar score, surgeon satisfaction of fetal departure time, relaxation of uterus during surgery, and bleeding volume were studied. Data were analyzed by using SPSS statistical software version 14, t-test, Mann Whitney, and chi-square tests. P value less than 0.05 was considered statistically significant.
Results: No significant differences were observed in terms of hemodynamic indices during surgery, apgar score (first minute p=0.172 and fifth minute p=0.347), and post-surgery hematocrit (p=0.745) between two groups. Surgeon was more satisfied with the fetal departure time in propofol group than in thiopental group and it was statistically significant (p=0.02). Before oxytocin administration, the uterus relaxation was significantly different between two groups, which was more soft and dough in the propofol group (p=0.018) but there were no significant differences after administration of oxytocin in 5, 10 and 15 Minutes between two groups (p=0.548, 0.201, 0.065, respectively).
Conclusion: Overall, propofol is an appropriate and safe drug and it can be alternatively used instead of thiopental without any negative effect on apgar score and prepares appropriate uterine relaxation during fetal delivery. So this drug has not any decrease in response to oxytocin and also, it relatively provides stable human dynamic status.

Keywords

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