Placental Transfer and Neonatal Effects of Propofol Administered During Cesarean Section

Duilland, Ph.; Lirzin, J. D.; Cockshott, I. D.; Jorrot, J. C.; Conseiller, C

doi:10.1097/00000542-198709001-00454

Cited by 10 publications

(5 citation statements)

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“…However, another study could not show any correlation between NACS and propofol levels. 3 Apgar scores at one and five minutes were significantly higher (P < 0_05) with shorter I-D times despite generally higher levels of propofol. This is an unexpected finding though there have been similar reports after thiopentone.…”

Section: Discussionmentioning

confidence: 88%

“…This confirms a previous report where the mean U A/UV ratio was 1.09 with I-D times of 13-45 minutes. 3 Studies with thiopentone have shown a mean UA/UV of 0.87 with I-D times of 8-22 minutes 20 and a mean UA/UV of 0.46 with I-D times of 4-7 minutes. 22 Distribution thus appears to be faster with propofol than with thiopentone.…”

Section: + ++ ++ + +++ + +++mentioning

confidence: 98%

“…4 Maternal and fetal levels of propofol have been reported in patients with incision to delivery times of 13 to 45 minutes. 3 Apgar and Neurologic and Adaptive Capacity Scores (NACS) were satisfactory. With longer I-D times, maternal and neonatal propofol levels will be lower and it is not possible to extrapolate these results to faster deliveries.…”

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confidence: 96%

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Maternal and Fetal Levels of Propofol at Caesarean Section

Gin

Gregory

Chan

et al. 1990

Anaesth Intensive Care

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Twenty women were given a bolus induction of propofol2. 0 mg.kg-I for elective caesarean section. Induction to delivery times rangedfromfive to fourteen minutes. At delivery the maternal venous (MV) concentrations ofpropofol rangedfrom 0.53 to 1.48 pg.mt-I umbilical vein (UV) 0.39 to 1.4 pg.mt-Iand umbilical artery (UA) 0.34 to 0.68 pg.mt-I MV propofol concentrations were always higher than corresponding UV concentrations. The mean (95% confidence interval) UVIMVratio was 0.65 (0.56-0. 74) and the mean UAIUVratio was 1.07 (0.99-1.15). Neither ratio was shown to be correlated with induction to delivery time. Distribution of propofol is rapid across the placenta and in the fetus. Apgar scores were higher with shorter incision to delivery times but were not correlated to umbilical levels of propofol. .

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Section: Discussionmentioning

confidence: 88%

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confidence: 98%

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Maternal and Fetal Levels of Propofol at Caesarean Section

Gin

Gregory

Chan

et al. 1990

Anaesth Intensive Care

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“…Both thiopentone and propofol cross the placenta readily. Thiopentone has been reported to have a UV: MV ratio equal to 1 [12], and propofol a mean ratio of 0.7 [3]. In addition, the different metabolism of the two drugs may play a role in their neonatal effects.…”

Section: Discussionmentioning

confidence: 99%

Neurobehavioural Effects of Propofol on the Neonate Following Elective Caesarean Section

Celleno

Capogna

Tomassetti

et al. 1989

British Journal of Anaesthesia

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Forty mothers undergoing elective Caesarean section under general anaesthesia were allocated randomly to receive either propofol 2.8 mg kg-1 (n = 20) or thiopentone 5 mg kg-1 (n = 20) for induction of anaesthesia. Twenty neonates delivered by uncomplicated vaginal delivery were evaluated also as unmedicated controls. Neurobehavioural examinations were carried out at 1, 4 and 24 h after delivery. Infants in the propofol group had lower Apgar scores at 1 and 5 min; 25% of them had muscular hypotonus at 5 min. This hypotonus was not noted during the Early Neonatal Neurobehavioural Scale (ENNS) examination. Newborn children examined 1 h after birth, after maternal anaesthesia with propofol, showed a depression in alert state, pinprick and placing reflexes, and mean decremental count in Moro and light. There was a generalized irritability in 25% of them. This depression was not observed at 4 h.

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“…There are conflicting reports of the neonatal effects of propofol administered during Caesarean section. An early study found no adverse effects (Dailland et al 1987). However, in a careful comparative study of Early Neonatal Neurobehavioural Scales and Apgar scores, infants whose mothers had received propofol 2.8 mgekg-l had lower Apgar scores at 1 and 5 min; 25% had muscular hypotonus at 5 min post delivery; more had depression in alert state, pinprick response and placing reflexes and 25% showed generalized irritability (Celleno et al 1989).…”

Section: Neurobehavioural Effects In Neonates Following Elective Caesmentioning

confidence: 99%

Propofol in paediatric anaesthesia

Morton

Johnston

White

et al. 1992

Pediatric Anesthesia

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Propofol has been used in paediatric anaesthesia since 1985 and an increasing body of evidence has shown that it is a safe, effective induction agent which has dose-related side-effects comparable with other agents. Pain on injection can be ameliorated by the use of antecubital veins or by pre-mixing an adequate amount of lignocaine with propofol immediately prior to administration. The pharmacokinetics of propofol are different in children with their larger central compartment volume and clearance reflected in higher dose requirements for induction and maintenance of anaesthesia. This has important implications when propofol is given for sedation or anaesthesia by continuous infusion. Volume of distribution at steady state (Vss, 1.kg-') Volume of distribution at equilibrium (Vy, bkg-') Volume of the central compartment (Vc, 1.kg-l) Total body clearance (U, ml.kg-'min-') Distribution half-life (THa, min) Metabolic half-life (T,@, min) Elimination half-life ( T, -y, min)

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Placental Transfer and Neonatal Effects of Propofol Administered During Cesarean Section

Cited by 10 publications

References 0 publications

Maternal and Fetal Levels of Propofol at Caesarean Section

Maternal and Fetal Levels of Propofol at Caesarean Section

Neurobehavioural Effects of Propofol on the Neonate Following Elective Caesarean Section

Propofol in paediatric anaesthesia

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