A Comparative Study on the Effects of Propofol and Thiopental on the Apgar score of Neonates Undergoing Cesarean Section under General Anesthesia: A Systematic Review Study

Introduction: Apgar score of neonates at birth is one of the determinants of postnatal mortality and one of the effective factors in Apgar score of cesarean section neonates that is the type of drug used for maternal anesthesia. Owing to the disagreement on the benefits and possible side effects of anesthetics, the present study was an attempt to evaluate and compare the effects of propofol and thiopental on the Apgar score of neonates undergoing cesarean section under the general anesthesia. Methods: The present study is a systematic review. Persian articles were searched in databases such as SID, Iranmedex, Magiran, and English articles were searched in databases such as Science Direct, PubMed, ProQuest, Cochrane Library, Embase, Scopus, and Google Scholar search engine without any time limitation. To access the full text of articles, the keywords of propofol, thiopental, general anesthesia, neonatal Apgar score, cesarean section, and their combination, the Boolean search methods, and conjunctions of “And” and “Or” were used. The information of reviewed articles included the first author, year of publication, the country of study, the sample size, and the outcome of the study. Results: A total of 27 articles were included to the study. In 22 studies, no statistically significant difference was found between thiopental and propofol effects on neonatal Apgar score at minutes 1 and 5. Also, in 4 studies, Apgar scores at minutes 1 and 5 were reported higher in the propofol group than the thiopental group. Furthermore, in one study, Apgar score at minute 1 was reported higher in the propofol group than the thiopental group. In three studies, Apgar score of neonates at the minute 1 in thiopental group was reported higher than the propofol group. Conclusion: It seems that neonates whose mothers underwent the general anesthesia with propofol for cesarean section have better Apgar scores than those who received thiopental. One of the effects of propofol is its shorter duration of action, and if the patient has a problem with difficult intubation, the effect of the drug ends sooner and the patient’s breathe returns as soon as possible. Likewise in this regard, compared to thiopental, which has a longer effect, Propofol is a more effective drug in cesarean section women under the general anesthesia.