Can propofol procedural sedation implementation increase the acceptance of spinal anesthesia during cesarean section?

• Main Authors: Alaa Mazy, Nadia Madkour, Hesham Shaalan
• Format: Article
• Language: English
• Published: SpringerOpen 2019-12-01
• Series: Ain Shams Journal of Anesthesiology
• Subjects: Spinal anesthesia; Cesarean section; Anxiety; Propofol; Conscious sedation; Sitting position
• Online Access: https://doi.org/10.1186/s42077-019-0043-9

Abstract Background Parturients are highly anxious preoperatively. The worries of spinal anesthesia may preclude its acceptance despite being recommended. Procedural sedation is not a routine during regional blocks, but it is sensible that anesthesiologists should provide their blocks comfortably. The proposal is that implementing the propofol procedural sedation (PPS) may increase the acceptance rate of spinal anesthesia for cesarean section. Methods In this prospective observational study, the patients who refused spinal anesthesia primarily were interrogated to implement PPS for painless comfortable spinal anesthesia. Their acceptance rate was the primary outcome. In the sitting position, propofol 0.7 mg/kg and 20 mg increments were used as required. Patients were well supported and monitored. Data were compared by Mann-Whitney, chi-square, Fisher’s exact, and Friedman’s ANOVA tests as appropriate. Results The acceptance rate of spinal anesthesia increased from 17 to 93%. During PPS, the mean values of minimal mean blood pressure were not significantly decreased, while the mean values of the heart rate slightly increased. The minimal values of oxygen saturation showed no significant reduction compared to the basal values. Patients expressed a marked relief of anxiety and high satisfaction. Conclusion The use of propofol procedural sedation was effective in increasing the acceptance rate of spinal anesthesia during CS with safety and high patient’s satisfaction.