2019 Volume 69 Issue 1-4 Pages 155-162
Background: We conducted a single-center retrospective study with propensity score matching to clarify which anesthetic agent, i.e., thiopental or propofol, provides better outcomes for newborns and women undergoing elective and/or urgent cesarean section with general anesthesia.
Methods: We collected maternal and fetal data (n=935) using obstetric and anesthetic charts of cesarean sections with general anesthesia between 1994 and 2013. After 1:1 propensity score matching with maternal age, body mass index, gestational period, fetal weight, type of surgery, pre-eclampsia, and fetal/maternal indication, we compared thiopental to propofol (n=392) regarding the following outcomes. The fetal primary outcome was their well-being evaluated by Apgar score (APS). The maternal primary outcome was the patient's hemodynamic changes due to tracheal intubation or delivery.
Results: The only APS at 1 min was significantly higher in the thiopental group. The other fetal outcomes such as APS at 5 minutes, the umbilical cord blood pH, and proportion of neonatal asphyxia after birth were similar between two groups. Regarding maternal outcomes, propofol significantly suppressed the increase in the patients' blood pressure from anesthetic induction to the delivery.
Conclusions: Our results indicate that propofol induction may be a first choice for cesarean section with general anesthesia.
