Abstract
Sixty unpremedicated ASA physical status I or II patients scheduled for surgical procedures of intermediate duration (15 to 60 min) were studied to evaluate the safety and efficacy of propofol, to measure recovery times and to compare the return of psychomotor and cognitive function with thiopentone. Patients were randomly allocated into two groups. Anaesthesia was induced and maintained by either propofol (2.0- 2.5 mg· kg- 1 followed by a continuous infusion 0.1- 0.2 mg· kg- 1 · min- 1) or thiopentone (4.0- 5.0 mg · kg- 1, and infusion rate 0.16- 0.32 mg · kg- 1 min- 1), titrated to patient response. Succinylcholine was administered to facilitate tracheal intubation and maintain neuromuscular blockade. Induction of anaesthesia was slightly longer with propofol than thiopentone (42.2 vs 29.8 sec) and was smooth with both drugs. Postintubation increases in heart rate, and systolic and diastolic blood pressures were attenuated by propofol when compared with thiopentone. After the administration of propofol, times to eye opening (6.4 ± 4.3 vs 13.9 ± 15.9 min), response to verbal command(7.6 ± 6.3 vs 15.4 ± 16.6 min) and orientation (22.7 ± 12.8 vs 36.2 ± 23.1 min), were significantly shorter. Psychomotor and cognitive function returned earlier with propofol and fewer side effects were noted. At 24 hr there was no distinguishable difference between groups. Propofol is a safe anaesthetic agent with the potential for early patient discharge and street fitness after outpatient procedures.
Résumé
Dans un effort pour établir la surété et I’efficacité du propofol, et pour en comparer les délais d’éveil et les effets sur la psychomotricité et sur les fonctions cognitives avec ceux du thiopental, nous avons conduit une étude prospective chez 60 patients randomisés de classe ASA I ou II lors d’interventions d’une durée de 15 a 60 minutes. Les patients recevaient soil du propofol (2,0- 2,5 mg · kg- 1 suivi d’une infusion a 0,1- 0,2 mg · kg- 1 · min- 1), soit du thiopental (4,0- 5,0 mg · kg- 1, infusion de 0,16- 0,32 mg- kg- 1 · min- 1) ajustés selon la réponse. On se servait de succinylcholine pour Iintubation de la trachée et pour maintenir le relâchement musculaire. L’induction de l’anesthéie s’est faite en douceur avec les deux anesthésiques quoique un peu plus lentement avec le propofol (42,2 vs 29,8 sec). L’augmentation du pouls et des pressions artérielles systolique et diastolique lors de I’intubation, était moins marquée avec le propofol qu’avec le thiopental. Les délais entre la fin de I’infusion et l’ouverture des yeux (6,4 ± 4,3 vs 13,9 ± 15,9 min), la réponse aux ordres verbaux (7,6 ± 6,3 vs 15,4 ± 16,6 min) et le retour de Vorientation (22,7 ± 12,8 vs 36,2 ± 23,1 min) étaient plus courts avec le propofol qu’avec le thiopental. Aprés une anesthisie au propofol, la récupération des fonctions psychomotrices et cognitives survenait plus rapidement avec moins d’effets secondaires quoique à 24 heures, les deux groupes soient indifférenciables. Lors de chirurgie en externe, le propofol est un anesthésique sûr permettant de donner congé précocément à des patients alertes.
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This study was supported by a grant from ICI Pharmaceuticals of Canada.
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Kashtan, H., Edelist, G., Mallon, J. et al. Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia. Can J Anaesth 37, 170–176 (1990). https://doi.org/10.1007/BF03005465
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DOI: https://doi.org/10.1007/BF03005465