Document Detail


Over half MAC sevoflurane in cesarean section.
MedLine Citation:
PMID:  16241019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Half MAC (minimal alveolar concentration) of volatile anesthetics has been commonly used with nitrous oxide for cesarean section which could occur intraoperative awareness. Over half MAC or more than 1% sevoflurane was studied on 65 parturients who came for either elective or emergency operations. The patient characteristics were age 31.00+/-5.67(21-41) years, BW 72.37+/-10.51 (52.6-117) kg, and ASA physical status 1, 52% for elective and 73% for emergency cases. The indications for operations were mostly CPD, fetal distress and previous cesarean sections. The anesthetic time was 59.19+/-17.35 (35-145) minutes while the induction-delivery time was 12.72+/-5.66 (3-28) minutes. General anesthesia was rapid sequence induction with propofol or thiopental and tracheal intubation under succinylcholine with the application of cricoid pressure. The depth of anesthesia was maintained with 1.5-3% sevoflurane until delivery and the volatile agent was lowered to 0.4-1%, adjusted to clinical manifestation. Midazolam and morphine were added postdelivery. Data of hemodynamic changes during delivery, neonatal outcome and intraoperative blood loss were analyzed without any remarkable note. The postoperative interview on recalls confirmed adequate depth of anesthesia. It was concluded that sevoflurane at more than 1% concentration could be used predelivery in cesarean sections on the issues of awareness, hemodynamics and fetal conditions but caution was suggested in terms of uterine relaxation effect which was dose-dependent.
Authors:
Siriwan Jirasiritham; Kamthorn Tantivitayatan; Piyamas Sirivararom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  88     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-10-24     Completed Date:  2005-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  914-20     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Ramathibodi Hospital, the Faculty of Medicine, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General / methods
Anesthesia, Obstetrical / methods*
Anesthetics, Inhalation / administration & dosage*
Awareness
Cesarean Section*
Female
Humans
Methyl Ethers / administration & dosage*
Pregnancy
Pregnancy Outcome
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane

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