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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 25 avril 2019
Doi : 10.1016/j.accpm.2019.04.002
Thiopental versus propofol on the outcome of the newborn after caesarean section: An impact study
 

Olivier Montandrau a, , Fabien Espitalier a , Joseph Bouyou b , Marc Laffon a , Francis Remérand a
a Department of anaesthesia and intensive care, Hôpital Trousseau, CHRU de Tours, 37044 cedex 9 Tours, France 
b Department of obstetrics and gynaecology, Hôpital Lariboisière AP–HP, 2, rue Ambroise Paré, 75010 Paris, France 

Corresponding author.
Summary
Background

In 2011, the company that produced thiopental in France and in the United States stopped its marketing. Because of limited evidences, the choice of the best induction agent for caesarean section remains controversial, especially in emergency. The objective of this study was to compare the effects of propofol versus thiopental on the Apgar score of the newborn.

Methods

Newborns delivered by elective or emergency caesarean section under general anaesthesia in a university hospital were included from January 2009 to December 2013. Two periods, according to the hypnotic drug used, were compared in this before-and-after comparative study: thiopental before May 2011 and propofol after. The primary outcome was to compare the proportion of newborns with a 5-minute Apgar Score < 7 between both groups.

Results

367 newborns were enrolled, 178 in thiopental group and 189 in propofol group . Demographic and clinical characteristics were similar in both groups. The occurrence of a 5-minute Apgar Score less than 7 was not influenced by the use of propofol (OR 1.40 [CI 95% 0.90–2.20] P  = 0.135). Blood gas analyses and admission's rate in neonatal intensive care unit were similar in both groups.

Conclusions

Thiopental and propofol do not appear to present significant difference in term of outcome of the newborn after caesarean section. In this situation, propofol may probably be a reliable alternative to the supply reduction of thiopental imposed by forces. Prospective studies are required to confirm the safety of propofol, particularly in the long term.

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Keywords : Anaesthetics i.v., Propofol, Anaesthetics i.v., Thiopental, Apgar score, Caesarean section, General anaesthesia




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