Patient Controlled Sedation Using Propofol during Regional Anesthesia for Cesarean Section.
10.4097/kjae.2000.39.4.534
- Author:
Woo Jae JEON
1
;
Do Hyun KIM
;
Duck Hwan CHOI
Author Information
1. Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Anesthetics, intravenous: propofol;
Hypnosis: patient-controlled sedation;
Surgery: cesarean section
- MeSH:
Anesthesia, Conduction*;
Anesthesia, Epidural;
Anesthesia, Spinal;
Antiemetics;
Bupivacaine;
Cesarean Section*;
Epinephrine;
Female;
Fentanyl;
Humans;
Hypotension;
Incidence;
Lidocaine;
Nausea;
Pregnancy;
Propofol*;
Shivering;
Sodium Bicarbonate;
Visceral Pain;
Vomiting
- From:Korean Journal of Anesthesiology
2000;39(4):534-541
- CountryRepublic of Korea
- Language:Korean
-
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.
