Highlights
- •This is an extension study of a previous publication.
- •Women were randomised to receive rocuronium or suxamethonium for caesarean section.
- •There were more 1-min Apgar scores <7 with rocuronium.
- •There were no differences in 5-min or 10-min Apgar scores.
- •There were no significant differences in umbilical arterial blood gases.
Abstract
Background
In a previous study we compared rocuronium and suxamethonium for rapid-sequence induction
of general anaesthesia for caesarean section and found no difference in maternal outcome.
There was however, a significant difference in Apgar scores. As this was a secondary
outcome, we extended the study to explore this finding on a larger sample.
Methods
We included 488 parturients of whom 240 were women from the original study. Women
were randomly assigned to receive either rocuronium 1 mg/kg (ROC n=245) or suxamethonium 1 mg/kg (SUX n=243) after propofol 2 mg/kg. Anaesthesia was maintained with up to 50% nitrous oxide and up to one minimum
alveolar concentration of sevoflurane until the umbilical cord was clamped. We compared
neonatal outcome using Apgar scores and umbilical cord blood gases.
Results
Data were analysed for 525 newborns (ROC n=263 vs. SUX n=262). There was a statistically significant difference in the proportion
of Apgar scores <7 at 1 min (ROC 17.5% vs. SUX 10.3%, P=0.023) but no difference at 5 min (ROC 8% vs. SUX 4.2%, P=0.1) or 10 min (ROC 3.0% vs. SUX 1.9%, P=0.58). There was no difference between groups in other measured outcomes.
Conclusion
The use of rocuronium was associated with lower Apgar scores at 1 min compared with suxamethonium. The clinical significance of this is unclear and
warrants further investigation.
Keywords
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Article info
Publication history
Published online: May 09, 2017
Accepted:
May 2,
2017
The preliminary results of this study were presented at the following congresses: Euroanaesthesia 2013, Barcelona, Spain; Euroanaesthesia 2014, Stockholm, Sweden; Euroanaesthesia 2015, Berlin, Germany; Anesthesiology 2015, San Diego, USA; Euroanaesthesia 2016, London, UK.Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
