Neurobehavioural Effects of Propofol on the Neonate Following Elective Caesarean Section

Abstract

Forty mothers undergoing elective Caesarean section under general anaesthesia were allocated randomly to receive either propofol 2.8 mg kg-1 (n = 20) or thiopentone 5 mg kg-1 (n = 20) for induction of anaesthesia. Twenty neonates delivered by uncomplicated vaginal delivery were evaluated also as unmedicated controls. Neurobehavioural examinations were carried out at 1, 4 and 24 h after delivery. Infants in the propofol group had lower Apgar scores at 1 and 5 min; 25% of them had muscular hypotonus at 5 min. This hypotonus was not noted during the Early Neonatal Neurobehavioural Scale (ENNS) examination. Newborn children examined 1 h after birth, after maternal anaesthesia with propofol, showed a depression in alert state, pinprick and placing reflexes, and mean decremental count in Moro and light. There was a generalized irritability in 25% of them. This depression was not observed at 4 h.

Propofol infusion anaesthesia for Caesarean section

“…23"24 Neurobehavioural assessment has been judged satisfactory after propofol (2.5 mg.kg-~) 27 although other workers have found lower scores after propofol (2.8 mg.kg -'l) than with thiopentone (5 mg. kg-~). 26 The NACS for the Chinese neonates in this study were less than those for non-Chinese. 12,27,28 All NACS were evaluated by the same paediatrician and were comparable with NACS 24 hr after normal vaginal deliveries and elective epidural Caesarean sections at this institution.…”

Variation in rapid sequence induction techniques: current practice in Wales

“…There have been several studies comparing propofol to thiopental for induction of anaesthesia for elective Caesarean section [20][21][22][23][24][25][26][27][28][29][30]. These have showed little difference in neonatal Apgar scores or umbilical blood gas analysis.…”

“…These have showed little difference in neonatal Apgar scores or umbilical blood gas analysis. Two studies [21,22] observed signs of lighter anaesthesia in the propofol group; however out of 516 women randomly allocated to propofol or thiopental [20][21][22][23][24][25][26][27][28][29][30] there were two episodes of recall, both occurring with thiopental [20,27]. Three studies [24,27,29] suggested an improved maternal recovery with propofol while four [20][21][22]30] found no difference.…”

Acute intermittent porphyria and Caesarean delivery

“…43 Indeed one authority questions its use for routine Caesarean delivery. 44 In spite of this, we believe it to be a suitable induction agent in the pregnant patient with AIP.…”