Sedation with Propofol plus Paracetamol in External Cephalic Version: An Observational Study

Abstract

Although the influence of neuraxial anesthesia or sedation with remifentanil in external cephalic version (ECV) is widely known, ECV results using propofol have not been previously analyzed. This study aimed to evaluate ECV outcomes when propofol was used. An observational analysis of ECV was performed between 1 January 2018 and 31 December 2020. ECV was accomplished with tocolysis and propofol. One hundred and thirty-one pregnant women were recruited. The propofol mean dose was 156.1 mg (SD 6.1). A cephalic presentation was achieved in 61.1% (80/131) of the pregnant women. In total, 56.7% (38/67) of pregnant women with cephalic presentation at labor had a spontaneous delivery, 26.9% (18/67) had an operative delivery, and an intrapartum urgent cesarean section was performed in 16.4% (11/67). In total, 46 pregnant women (35.9%) were scheduled for an elective cesarean section due to non-cephalic presentation. The emergency cesarean section rate during the following 24 h was 10.7% (14/131). A major ECV complication arose in 15 cases (11.5%). ECV outcomes when propofol was used seems to be similar to those with other anesthetic adjunct, so sedation with propofol could be an adequate option for ECV. More studies are needed to compare its effectiveness with neuraxial techniques.

Effect of Super-Specialization in External Cephalic Version: A Comparative Study

“…Several studies proved that analgesia [8,[12][13][14][15][16]20] and tocolysis [8,11] improve the ECV success rate. The present study had remarkable procedure characteristics such us, as far as we are concerned, it is the first group in which propofol is used for deep sedation in ECV, and what tocolysis concerned, ritodrine is administered for half-hour just before the procedure [21,22].…”

“…ECV was performed following the same protocol in both groups [21,22]. Our group published a previous study describing the procedure [21] and analyzing the role of sedation with propofol [22].…”

“…ECV was performed following the same protocol in both groups [21,22]. Our group published a previous study describing the procedure [21] and analyzing the role of sedation with propofol [22]. The procedure was carried out in the operating room in the presence of a midwife and an anesthesiologist.…”

“…In the operating room, vital signs were monitored (Temperature, noninvasive blood pressure, heart rate, Electrocardiogram (EKG), and oxygen saturation). The patient was positioned in Trendelenburg (15º) and administered 1-1.5 mg/kg of propofol [22]. Paracetamol was used as analgesic agent.…”