| dc.description.abstract | A prospective study comparing the haemodynamic effect of Thiopentone and Propofol
for induction of anaesthesia for caesarean section for 90 pre-eclamptic/ eclamptic
mothers was carried out at Kenyatta National Hospital maternity theater.
Randomly allocated, Thiopentone and Propofol III the standard induction dosage of
4mg/kg and 2mg/kg respectively was used on 90 pre-eclamptic/ eclamptic patients
undergoing caesarean section. The 2 groups were comparable in age, parity and
distribution.
Systolic, mean and diastolic arterial pressure and heart rate were recorded non-invasively,
on arrival at the theater, following intubation, prior to, during and post-induction of
anaesthesia, at 2minutes, 4minutes, at delivery of baby and 5 minutes after delivery.
The study found that the heart rate increased from 125 beats/min to 138beats/min
(13beats/min increase) following induction and intubation with Thiopentone, and
remained elevated by 7 beats/min up to 5 minutes post-delivery of the baby. However,
following induction and intubation with Propofol, the Heart rate increased from 123-
beats/min t0129 beats/min (6beats/min increase) and returned to baseline values by
Sminutes post-delivery of the baby. The difference in rise in the heart rate between the
two drugs was statistically significant (p-value< 0.05)
There was a significant increase in systolic blood pressure in the Thiopentone group from
155mmHg to 168mmHg (13mmHg increase) post- induction, whereas in the Propofol
group the post-induction systolic blood pressure was same as baseline values of
152mmHg(OmmHgincrease). (P value <0.05).The only rise in systolic blood pressure in
the Propofol group was during induction, 9mmHg, but this was not statistically
significant compared with the rise in Thiopentone group of 5mmHg.
There was a significant increase in the diastolic blood pressure from 108mmHg to
114mmHg(6mmHg raise) post-induction in the Thiopentone group compared to the fall
in the Propofol group from 106mmHgto 103mmHg(3mmHg fall) (p-value <0.05).In the
two groups the diastolic blood pressure consistently fell up to 86-87mmHg at 5 minutes
post delivery of the baby.
The mean arterial pressure rose from 123mmHg to 134mmHg (llmmHg increase) in the
Thiopentone group post-induction whereas it only rose by 1mmHg (from 120mmHg to
121mmHg) in the Propofol group. This was significant (p-value <0.05). It then
consistently fell in both groups to l05mmHg by Sminutes post delivery of the baby.
During induction, the rise in all the parameters was minimal and was statistically
insignificant.
The median age of the 90 patients studied was 2S years with the minimum age being 14
years and the maximum age 38 years. The mode was 20 years. The mean age being
2S.367years.
The median Parity was 0 with the minimum parity being nullipara and the maximum
Parity being S.000. The mode was Para O.
There was a hypertensive response to intubation in the Thiopentone group which was
absent in the Propofol group and a greater rise in heart-rate post-intubation with
thiopentone as compared to Propofol. The investigation thus found Propofol to cause less
variation in arterial pressure and heart-rate than Thiopentone in Pre-eclamptic/ eclamptic
mothers.
Pre- eclampsia! eclampsia, was found to be a disease occurring predominantly in young
nulliparas. | en |
| dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
