[The pharmacokinetics of propofol used in cesarean section; a preliminary study in the newborn infant].
A prospective study was carried out: 1) To compare the pharmacokinetics of propofol in two groups of patients: group 1 (eight pregnant women undergoing a prophylactic caesarean section at term), group 2 (control group: eight non pregnant women anaesthetized for short gynaecological procedures). 2) To study the kinetics of this agent in five newborns. Both groups were similar for weight, age, ASA I, oral premedication, anaesthetic method and duration. Dosages were performed using HPLC and results were statistically compared by Student's t-test. The haemodynamic parameters did not show large variations during induction. Propofol plasma levels were high (4,600 +/- 2,200 ng/ml-1) at intubation time; however, at extraction time (group 1) or 25 minutes after induction (group 2), plasma levels were close to anaesthetic threshold. The decreasing slopes were similar in the two groups. The quality of recovery in both groups was satisfactory. The first measured level in umbilical cord blood after birth was low, close to half of the maternal level, without any constant correlation. During the first hour of life, the drug catabolism is lesser in the newborn than in its mother, then plasmatic concentrations decrease similarly. Apgar scores were excellent in four of the five studied newborns; one child had a mean score notwithstanding a low propofol level (171 ng/ml-1), but recovery was perfect after a short oxygenation. There was no significant difference between pregnant women and control group with the propofol dose of 4 mg/kg-1 used for anaesthesia. Thus propofol appears to be convenient for prophylactic caesarean section without damage for the newborn.
Cortambert
F
F
Département d'Anesthésie-Réanimation, Hôpital Edouard Herriot, Lyon.
Marti-Flich
J
J
Dasset
M P
MP
Mullet
C
C
D000771:Anesthesia, Intravenous; D000773:Anesthesia, Obstetrical; D000777:Anesthetics / Q000097:blood / Q000493:pharmacokinetics*; D001034:Apgar Score; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn / Q000097:blood / Q000378:metabolism; D008431:Maternal-Fetal Exchange; D010636:Phenols / Q000097:blood / Q000493:pharmacokinetics*; D011247:Pregnancy; D015742:Propofol; D011446:Prospective Studies
D000777:Anesthetics; D010636:Phenols; D015742:Propofol
Etude de la pharmacocinétique du propofol pour l'intervention césarienne; étude préliminaire chez le nouveau-né.