Intravenous infusion of low dose propofol for conscious sedation in cesarean section before spinal anesthesia

Conscious sedation, not affecting the safety of both mother and fetus, is especially favorable in anxious patients undergoing Cesarean delivery. However, when sedation is started before performing intrathecal anesthesia, the infusion time before delivery will be prolonged. In this study, the incidence of maternal and fetal complications under propofol infusion were evaluated as well as the blood concentrations of propofol during delivery at different time of sedation.

Maternal and fetal effects of pre-spinal sedation with low dose propofol infusion technique (3 mg/mg/h following 0.3 mg/kg bolus) in 37 Cesarean parturients were evaluated, compared with another 33 parturients under spinal anesthesia without any sedatives.

The induction to delivery time was 32.6 +/- 7.7 min. Satisfactory, airway-maintaining conscious sedation was shown without increasing the incidence of post-spinal hypotension and hypoxemia compared with non-sedative group. The plasma propofol concentrations in the mean time of delivery in maternal vein and umbilical vein were 0.86 +/- 0.29 and 0.33 +/- 0.11 microgram/ml, respectively. Umbilical venous concentration neither correlated with infusion time nor exceeded the maternal venous concentration. The 1-min and 5-min Apgar scores as well as umbilical venous blood gas analyses did not differ significantly between two groups.

Conscious sedation by low dose propofol infusion is safe for both mother and fetus in spite of longer infusion time.