Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial

Autor:	Fatemeh Mirhadi, Elham Asadpour, Seyed Mostajab Razavi, Laleh Dehghanpisheh, Zeinabsadat Fattahi Saravi, Mohammad Reza Hadavi, Farid Zand, Golnar Sabetian
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Adult medicine.medical_specialty General anesthesia Succinylcholine Sevoflurane law.invention Young Adult Consciousness Monitors Randomized controlled trial law Pregnancy Anesthesiology medicine Anesthesia Obstetrical Humans Single-Blind Method RD78.3-87.3 Apgar score Thiopental Dose-Response Relationship Drug business.industry Research Infant Newborn Newborn Anesthesiology and Pain Medicine Muscle relaxation Sodium thiopental Bispectral index Anesthesia Anesthetic Female business Cesarean section Anesthetics Intravenous medicine.drug
Zdroj:	BMC Anesthesiology, Vol 21, Iss 1, Pp 1-8 (2021) BMC Anesthesiology
ISSN:	1471-2253 2016-0828
Popis:	Background Administration of an optimal dose of anesthetic agent to ensure adequate depth of hypnosis with the lowest risk of adverse effects to the fetus is highly important in cesarean section. Sodium thiopental (STP) is still the first choice for induction of anesthesia in some countries for this obstetric surgery. We aimed to compare two doses of STP with regarding the depth of anesthesia and the condition of newborn infants. Methods In this clinical trial, parturient undergoing elective Caesarian section were randomized into two groups receiving either low-dose (5 mg/kg) or high-dose (7 mg/kg) STP. Muscle relaxation was provided with succinylcholine 2 mg/kg and anesthesia was maintained with O2/N2O and sevoflurane. The depth of anesthesia was evaluated using isolated forearm technique (IFT) and bispectral index (BIS) in various phases. Additionally, infants were assessed using Apgar score and neurobehavioral test. Results Forty parturient were evaluated in each group. BIS was significantly lower in high-dose group at skin incision to delivery and subcutaneous and skin closure. Also, significant differences were noticed in IFT over induction to incision and incision to delivery. Apgar score was significantly lower in high-dose group at 1 min after delivery. Newborn infants in low-dose group had significantly better outcomes in all three domains of the neurobehavioral test. Conclusion 7 mg/kg STP is superior to 5 mg/kg in creating deeper hypnosis for mothers. However, it negatively impacts Apgar score and neurobehavioral test of neonates. STP seems to has dropped behind as an acceptable anesthetic in Cesarean section. Trial registration IRCT No: 2016082819470 N45, 13/03/2019.
Databáze:	OpenAIRE
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