[jdpete]

Just a question out there to see who is using diprivan for stat c sections and who all still use Pentothal and what experiences these have had for you---

[jwk]

Originally Posted by jdpete

Just a question out there to see who is using diprivan for stat c sections and who all still use Pentothal and what experiences these have had for you---

Still pentothal where I am, but we probably only do 1% of our C/S with a general. One of the hospitals where I do locums uses propofol. No problems that I've seen.

[Nitecap]

STP here too. Usually for stat C-sections where neuraxial not an option. Really as soon as the tube is in they are tearing the baby out. Asked a few attendings and they claimed that propofol may be just as safe as STP however STP has been more extensively studied and has more evidence to support it as being safe with minimal traces found in cord of neonate blood.

Since there is more data to support it we use this for nearly all GA C-sections.

[catcolalex]

does the fact that STP can be mixed and set out ready on the cart have anything to do with its prevelence in OB as opposed to propofol that would have to be drawn up at the time?

[jwk]

Originally Posted by catcolalex

does the fact that STP can be mixed and set out ready on the cart have anything to do with its prevelence in OB as opposed to propofol that would have to be drawn up at the time?

Not really - you can buy pre-filled syringes of propofol that can sit out as long as you want.

[Geeg]

Hey, I'm not a CRNA, but isn't dip more expensive??

[Nitecap]

Originally Posted by Geeg

Hey, I'm not a CRNA, but isn't dip more expensive??

Yes but not as expensive as it used to be since its been around alot longer and is made by 2 companies now.

[sonessrna]

I have heard (and not recently )that propofol has been shown to cause significant fetal sedation. I have never used propofol, don't know. Just what I heard.

[sonessrna]

Originally Posted by Nitecap

Yes but not as expensive as it used to be since its been around alot longer and is made by 2 companies now.

If propofol is a better drug, cost should not be an issue. Cost should not be the main issue, patient care should. Just my speech.

[jwk]

Originally Posted by sonessrna

I have heard (and not recently )that propofol has been shown to cause significant fetal sedation. I have never used propofol, don't know. Just what I heard.

I've never found that to be the case, nor have I ever heard it.

Interesting that propofol is Pregnancy Category B, and pentothal is Pregnancy Category C, theoretically LESS safe, but since pentothal is the old tried-and-true drug, there doesn't seem to be any push to change.