Title: General anaesthesia with target controlled infusion of propofol for planned caesarean section: maternal and neonatal effects of a remifentanil-based technique
Authors: Van de Velde, Marc ×
Teunkens, A
Kuypers, M
Dewinter, T
Vandermeersch, Eugene #
Issue Date: Jul-2004
Series Title: International journal of obstetric anesthesia vol:13 issue:3 pages:153-8
Abstract: The present case series evaluated maternal and neonatal effects of remifentanil, combined with propofol, during general anaesthesia for caesarean delivery. Following written informed consent, ten patients scheduled for semi-elective caesarean section were recruited to this prospective, unblinded trial. All patients with non-reassuring fetal status were excluded. A 0.50-micrograms/kg bolus of remifentanil was given intravenously, followed by a continuous infusion of 0.20 Anaesthesia was induced using propofol target controlled infusion set at a blood concentration of 5 micrograms/mL, 45 s after the remifentanil bolus. Following tracheal intubation the propofol target was reduced to 2.5 micrograms/mL and remifentanil maintained at 0.20 Mean arterial pressure remained stable throughout anaesthesia. Two patients experienced episodes of hypotension (mean arterial pressure decrease >20%). Although neonatal depression occurred in six babies and assisted mask ventilation was required briefly, recovery was rapid without the need for naloxone or tracheal intubation. Umbilical artery pH was >7.20 in all infants. We conclude that the results of the present case series using a remifentanil/propofol-based technique of general anaesthesia for caesarean section provide a basis to study the safety of this technique in a larger population. Under the conditions of the present trial, this anaesthetic technique seems safe for mother and infant, provided adequate precautions are taken to manage brief, self-limiting infant respiratory depression. At the moment we cannot advise the routine use of this technique, especially since it has not been studied in situations of fetal compromise.
ISSN: 0959-289X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Anesthesiology and Algology
× corresponding author
# (joint) last author

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