During cesarean section, rapid anesthesia induction is required by administering a high concentration of muscle relaxant to reduce the difficulty of tracheal intubation and complications caused by various general anesthetic agents. In general anesthesia, muscle relaxants are also essential for ease of surgery and reduction of body tissue damage and cardiovascular responses. However, muscle relaxants often delay breath recovery after surgery, resulting in the use of ventilators. It can also be transmitted to the fetus through the placenta. In fact, this experiment was devised to find out whether it is appropriate for a mother and a fetus to use a high concentration of muscle relaxant by measuring the concentration of muscle relaxant passing through the placenta.
Only those applicants who have made a cesarean section due to general anesthesia by posting a recruitment notice will conduct the experiment. It is divided into a low-concentration group (0.6mg/kg) and a high-concentration group(1.0mg/kg), followed by anesthesia and muscle relaxant administration, intubation time, ease of intubation, skin incision time, umbilical cord clamping time, T1 appearing time, T2 appearing time, extubation The time, TOF0.9 time, eye open time, recovery room exit time, total rocuronium amount entered, total remifentanil amount, Apgar score, complication, etc. are recorded. After dropping 60 μl of the patient's blood onto the electrode on a screen-printed slide, and measuring the chronoamperometry after 3 minutes, obtain a current signal according to the concentration of rocuronium present in the blood and calculate the concentration of rocuronium through calculation. Layer. Rocuronium concentrations are detected in maternal venous blood just before ligation of umbilical cord blood, umbilical vein blood, and venous blood of pregnant mother just before leaving the recovery room.
The aim is to observe the concentration of rocuronium that has actually passed umbilical cord blood, and compare side effects between both groups.

Cohort/Group Label

Low dose

Cohort/Group Description

In a low-concentration group, we administer 0.6mg/kg rocuronium. After the induction, we check  intubation time, ease of intubation, skin incision time, umbilical cord clamping time, T1 appearing time, T2 appearing time, extubation The time, TOF0.9 time, eye open time, recovery room exit time, total rocuronium amount entered, total remifentanil amount, Apgar score, complication, etc. are recorded. After dropping 60 μl of the patient's blood onto the electrode on a screen-printed slide, and measuring the chronoamperometry after 3 minutes, obtain a current signal according to the concentration of rocuronium present in the blood and calculate the concentration of rocuronium through calculation. Rocuronium concentrations are detected in maternal venous blood just before ligation of umbilical cord blood, umbilical vein blood, and venous blood of pregnant mother just before leaving the recovery room.

Cohort/Group Label

High dose

Cohort/Group Description

In a high-concentration group, we administer 1.0mg/kg rocuronium. After the induction, we check  intubation time, ease of intubation, skin incision time, umbilical cord clamping time, T1 appearing time, T2 appearing time, extubation The time, TOF0.9 time, eye open time, recovery room exit time, total rocuronium amount entered, total remifentanil amount, Apgar score, complication, etc. are recorded. After dropping 60 μl of the patient's blood onto the electrode on a screen-printed slide, and measuring the chronoamperometry after 3 minutes, obtain a current signal according to the concentration of rocuronium present in the blood and calculate the concentration of rocuronium through calculation. Rocuronium concentrations are detected in maternal venous blood just before ligation of umbilical cord blood, umbilical vein blood, and venous blood of pregnant mother just before leaving the recovery room.

Not collect nor Archive

Adult patients over 18 years of age who have undergone a cesarean section,I and II American Society of Anesthesiology.

If the patient agrees to the experiment, the patient is assigned a random number from 1 to 20 numbers, and the odd number belongs to the high concentration and the even number falls to the low concentration group. The number of researchers per group is ten.

Gender

Age

Description

Adult patients over 18 years of age who have undergone a cesarean section, ASA I and II

If the patient disagrees, a neuropsychiatric disorder, a history of medication or muscle relaxant administration that may affect pre-operative muscle relaxants, kidney failure, or liver failure

Rocuronium concentration of umbilical vein after umbilical cord clamping

at the time of decision to leave the recovery room

Time from the time the muscle relaxant was given until the tracheal intubation

at the tracheal intubation

Skin incision time from the time the muscle relaxant was given

at the skin incision

Time for umbilical cord clamping from the time the muscle relaxant was given

at the umbilical cord clamping

Side effects in mother and fetus

at the time to leave the recovery room

Rocuronium concentration of maternal vein after umbilical cord clamping and PACU discharge

after umbilical cord clamping and at chiacharge from PACU

No demographic differences were observed between the two groups. Additionally, no significant differences were found in intubation ease, time from rocuronium administration to skin incision, cord clamping, TOF ratio > 0.9, eye opening, extubation, PACU stay time, 1 min and 5 min Apgar score and venous blood gas analysis of the blood from the umbilical vein between both groups. However, the time from rocuronium administration to T3 disappearance was shorter in H group than in C group (p=0.009). The time from rocuronium administration to T1 and T2 reappearance were longer in H group than in C group (p=0.003, 0.009). The administered remifentanil dose was higher in H group (p=0.042), and the rocuronium concentrations in both maternal vein immediately before cord clamping and after the Aldrete score reached 9 and umbilical vein immediately after cord clamping were higher in H group than in C group (p=0.004, 0.002, and <0.001).