제왕절개술시 Propofol - N2O 마취가 술중 산모의 각성과 신생아에 미치는 영향

Background : In anesthesia for cesarean section, there is an increased incidence of maternal awareness because a light plane of general anesthesia is chosen for fetal safety and rapid recovery. Propofol may be the choice if smooth induction and rapid maternal recovery are desired. Authors tried to know that propofol has properties which suggest that it might be useful alternative to thiopental and enflurane. Methods : Forty patients in ASA class I or II scheduled for cesarean section were allocated randomly to either propofol(n=20)(P) or thiopental-enflurane(n=20)(T-E) group. Anesthesia was induced with propofol 2 mg/kg IV and maintained by continuous infusion of propofol 8 mg/kg/hr in P group and was induced with thiopental 4 mg/kg IV and maintained by inhalation of 1 vol% enflurane in T-E group. All patients received vecuronium 0.1 mg/kg and 50% N2O-O2. Blood pressure, heart rate, Apgar score, umbilical arterial blood gas analysis and the incidence of maternal awareness using the isolated forearm technique(IFT) were evaluated Results : Diastolic pressure was decreased in P group than T-E group at 10 min after delivery. Heart rate was increased in P group than T-E group at immediate after extubation(P＜0.05). For apgar score, umbilical artery gas analysis and maternal awareness there were not significant differences between two groups. Conclusions : In comparison with thiopental-enflurane, propofol infusion(8 mg/kg/hr) coupled with N2O was proved to be clinically satisfactory anesthesia for cesarean section with no adverse effects on both mother and neonate. (Korean J Anesthesiol 1998; 34: 814∼820)