A return to trichloroethylene for obstetric anaesthesia

Area of Science:

• Anesthesiology
• Obstetrics
• Neonatology

Background:

• Methoxyflurane has been a standard anesthetic agent.
• Evaluating alternative anesthetic agents is crucial for patient safety and outcomes.
• Trichloroethylene is an older anesthetic agent with a favorable toxicity profile.

Purpose of the Study:

• To compare the anesthetic effects of trichloroethylene and methoxyflurane in elective Cesarean sections.
• To assess the impact of anesthetic agent choice on maternal and neonatal outcomes.
• To evaluate the influence of surgical timing on neonatal well-being during Cesarean delivery.

Main Methods:

• A comparative study involving 405 patients undergoing elective Cesarean sections.
• Patients were divided into two groups receiving either trichloroethylene or methoxyflurane anesthesia.
• Maternal and neonatal outcomes, including postoperative symptoms, Apgar scores, and acid-base status, were recorded.

Main Results:

• No significant differences were observed in postoperative nausea, vomiting, or headache between the two anesthetic groups.
• An increased incidence of intraoperative awareness was noted in the trichloroethylene group (5.1% vs. 3.5%).
• Neonatal Apgar scores and materno-foetal acid-base gradients showed no significant differences. The interval between uterine incision and delivery was significantly associated with neonatal depression.

Conclusions:

• Trichloroethylene can be considered a viable alternative to methoxyflurane for anesthesia in elective Cesarean sections, given its comparable safety profile and lower cost.
• Anesthesia providers should be aware of the increased risk of awareness with trichloroethylene.
• The duration of the interval from uterine incision to delivery is a critical factor influencing neonatal outcomes, independent of the anesthetic agent used.