Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-021-01421-7 |
| _version_ | 1819097029675057152 |
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| author | Golnar Sabetian Farid Zand Fatemeh Mirhadi Mohammad Reza Hadavi Elham Asadpour Laleh Dehghanpisheh Zeinabsadat Fattahi Saravi Seyed Mostajab Razavi |
| author_facet | Golnar Sabetian Farid Zand Fatemeh Mirhadi Mohammad Reza Hadavi Elham Asadpour Laleh Dehghanpisheh Zeinabsadat Fattahi Saravi Seyed Mostajab Razavi |
| author_sort | Golnar Sabetian |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-22T00:08:36Z |
| format | Article |
| id | doaj.art-1b9d9d4d658449d1a49d98a0c800987f |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-22T00:08:36Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-1b9d9d4d658449d1a49d98a0c800987f2022-12-21T18:45:30ZengBMCBMC Anesthesiology1471-22532021-08-012111810.1186/s12871-021-01421-7Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trialGolnar Sabetian0Farid Zand1Fatemeh Mirhadi2Mohammad Reza Hadavi3Elham Asadpour4Laleh Dehghanpisheh5Zeinabsadat Fattahi Saravi6Seyed Mostajab Razavi7Trauma Research Center, Shiraz University of Medical SciencesAnesthesiology and Critical Care Research Center, Shiraz University of Medical SciencesTrauma Research Center, Shiraz University of Medical SciencesAnesthesiology and Critical Care Research Center, Shiraz University of Medical SciencesAnesthesiology and Critical Care Research Center, Shiraz University of Medical SciencesAnesthesiology and Critical Care Research Center, Shiraz University of Medical SciencesAnesthesiology and Critical Care Research Center, Shiraz University of Medical SciencesNeonatal Research Center, Shiraz University of Medical SciencesAbstract 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.https://doi.org/10.1186/s12871-021-01421-7General anesthesiaApgar scoreCesarean sectionNewbornThiopental |
| spellingShingle | Golnar Sabetian Farid Zand Fatemeh Mirhadi Mohammad Reza Hadavi Elham Asadpour Laleh Dehghanpisheh Zeinabsadat Fattahi Saravi Seyed Mostajab Razavi Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial BMC Anesthesiology General anesthesia Apgar score Cesarean section Newborn Thiopental |
| title | Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial |
| title_full | Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial |
| title_fullStr | Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial |
| title_full_unstemmed | Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial |
| title_short | Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial |
| title_sort | adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section a randomized clinical trial |
| topic | General anesthesia Apgar score Cesarean section Newborn Thiopental |
| url | https://doi.org/10.1186/s12871-021-01421-7 |
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