| Patient Controlled Sedation Using Propofol during Regional Anesthesia for Cesarean Section. |
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Woo Jae Jeon, Do Hyun Kim, Duck Hwan Choi |
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Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
During regional anesthesia for a cesarean section, adverse effects such as nausea and/or vomiting (N&V), visceral pain and shivering are common complications.
A subhypnotic dose of propofol has been known to have an antiemetic effect perioperatively. Patient controlled sedation (PCS) using propofol might be a solution for emesis and other adverse effects occurring during regional anesthesia in cesarean deliveries.
METHODS
One hundred ten parturients scheduled for elective cesarean section were randomly divided into two groups: PCS-spinal (n = 55) and PCS-epidural (n = 55). Spinal anesthesia was performed with 0.5% bupivacaine 10 mg and 10 microgram of fentanyl. Epidural anesthesia was performed with 2% lidocaine 25 ml + 100 microgram of fentanyl + 0.1 mg of epinephrine + 1.5 ml of 8.4% sodium bicarbonate in the PCS-epidural group. After delivery, PCS with propofol was applied to the patients in both groups (bolus dose: 30 mg, lock-out time: 3 min, no background infusion). We investigated incidences of adverse effects such as N&V, hypotension, intraoperative visceral pain, and shivering during the operation. We also assessed sedation scores (Grade 1 - 5) in the patients of both groups.
RESULTS
There was no difference in sensory levels between the groups. Although more patients in the PCS-epidural group complained of N&V (3.6%:20%, P = 0.018) and shivering (0%:14.5%, P = 0.036) in the PACU, there were no differences intraoperative adverse effects between both groups. The sedation score did not differ between the groups.
CONCLUSIONS
With PCS using propofol, adverse effects during cesarean section under both regional anesthesias are negligible. |
| Key Words:
Anesthetics, intravenous: propofol; Hypnosis: patient-controlled sedation; Surgery: cesarean section |
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