Article Notes
Article pearls, summaries and comments.
What's significant here is not confirmation that spinal anaesthesia improves ECV success, which has been noted before, but rather that this is not due to the analgesic effect as previously thought (ie. IV remifentanil improved pain during the ECV but not success rate), but instead may be primarily due to abdominal muscle relaxation.
Given the relatively low propofol TCI target (NB: 50% wake @ 1.07 mcg/mL and 50% orientated @ 0.95 mcg/mL), even in the presence of remifentanil, I wonder whether this is more a case of unrecognized light anaesthesia than sugammadex waking someone up.
Case in point, the demonstrated effect of rocuronium on BIS in awake volunteers: Response of bispectral index to neuromuscular block in awake volunteers