Abstract
This was a randomized study of 180 ASA physical status I and II patients, 60 in each group who received propofol (PROP), 2.5 mg·kg-1, thiopentone (THIO), 4 mg·kg-1, or methohexitone (METH), 1.5 mg·kg-1. Control values, followed by changes after induction and during a 3-min delay before intubation were recorded for the following parameters: heart rate (HR), systolic and diastolic blood pressures (SBP, DBP), respiratory rate (RR), end—tidal CO2 (PetCO2), and induction time (IT). In addition, the incidence of adverse reactions and time for recovery from anaesthesia were noted. The IT (mean ± SE) was 35 ± 1 sec for propofol, 35 ± 1.2 sec for thiopentone and 34 ± 1.4 sec for methohexitone. Ninety-three per cent of the PROP group fell asleep with one dose and required no additional doses. Fifty per cent of each of the THIO and METH groups required additional agents (p < 0.05). METH was associated with the highest elevation in HR, PROP the least (p < 0.05). PROP was associated with the most decrease in SBP and DBP and in addition respiratory depression (p < 0.05). The incidence of injection pain or excitatory activity was equal in the three groups with the exception that 14 patients who received METH developed hiccoughs while none did in the other groups. PROP was associated with the most rapid recovery, particularly with respect to the orientation time. We conclude that PROP is an effective alternative to barbiturate induction and that the published recommended doses of THIO and METH are often ineffective.
Résumé
Voici une étude aléatoire de 180 patients de statut physique ASA I et II, divisés en trois groupes de 60, qui ont reçu 2.5 mg·kg-1 de propofol (PROP), ou 4mg·kg-1 de thiopental (TWO), ou 1.5 mg·kg-1 de méthohexital (METH). Les valeurs-témoins, suivies de changements après ľinduction et durant un délai de trois minutes avant ľintubation, ont été enregistrées pour les paramètres suivants: fréquence cardiaque (FC), pression artérielle systolique et diastolique (PAS, PAD), fréquence respiratoire (FR), CO2 de fin ďexpiration (PetCO2), et temps ďinduction (TI). De plus, on a inscrit ľincidence de réactions adverses et le temps de rétablissement de ľahesthésie. Le TI (moyenne · SE) était de 35 · 1 sec pour le propofol, 35 · 1.2 sec pour le thiopental et 34 · 1.4 sec pour le méthohexital. Quatre-vingt-treize pour cent des patients du groupe PROP se sont endormis après ľadministration ďune dose et n’ont requis aucune dose additionnelle. Cinquante pour cent des patients du groupe THIO et du groupe METH ont requis des doses additionnelles des agents respectifs (p < 0.05). La plus grande augmentation de la FC fut associée au METH tandis que la plus petite fut associée au PROP (p < 0.05). Le PROP fut associé à la plus grande diminution de la PAS et de la PAD et à une dépression respiratoire (p < 0.05). Ľincidence de la douleur ou ďactivité ďexcitation à ľinjection était égale dans tes trois groupes à ľexception de 14 patients du groupe METH qui ont eu un hoquet alors que ceci ne s’est produit chez aucun patient des autres groupes. Le PROP a été associé au rétablissement le plus rapide, concernant plus particulièrement le temps ďorientation. Nous concluons que le PROP est une alternative efficace à ľinduction aux barbituriques et que les doses recommandées de THIO et de METH dans les publications sont souvent inefficaces.
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Gold, M.I., Abraham, E.C. & Herrington, C. A controlled investigation of propofol, thiopentone and methohexitone. Can J Anaesth 34, 478–483 (1987). https://doi.org/10.1007/BF03014354
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DOI: https://doi.org/10.1007/BF03014354