Hu L, et al. – The objectives of this study are to depict the administration of propofol in combination with remifentanil for the induction of general anesthesia during cesarean section (CS) and to assess its effect on the drug concentrations of the maternal and neonatal blood at different induction of anesthesia to delivery (I–D) intervals and also its impact on newborns. The current study shows that it is safe to administer propofol in combination with remifentanil by continuous infusion after the bolus dose for the induction of anesthesia amid cesarean section. Prolonging the I–D interval within a certain limit will not have any important effect on the fetus.

Methods

• For this study, they designed double–blind randomized controlled study.
• In this study, patients undergoing elective CS were administered anesthesia at short (n = 20) or long (n = 20) I–D intervals.
• Anesthesia was induced with 1 mg/kg propofol and 1 μg/kg remifentanil and maintained by continuous infusion of 3 mg/kg/h propofol and 7 μg/kg/h remifentanil.

Results

• The mean plasma propofol concentrations at delivery in the maternal arterial (MA) blood and the fetal umbilical arterial (UA) and venous (UV) blood in the short I–D interval group were 1.91, 1.17, and 0.51 μg/mL, respectively, while those in the long I–D interval group were 1.57, 1.07, and 0.61 μg/mL, respectively.
• The mean plasma remifentanil concentrations at delivery in the MA, UA, and UV in the short I–D interval group were 2.25, 1.43, and 0.65 ng/mL, respectively, and those in the long I–D interval group were 1.96, 1.25, and 0.75 ng/mL, respectively.
• No statistically significant differences were seen in the neonatal Apgar scores and neurological adaptive capacity scores between the two groups.