Propofol anaesthesia versus paracervical blockade with alfentanil and midazolam sedation for outpatient abortion.
Propofol anaesthesia was compared with paracervical blockade in a prospective, randomized study of 59 abortion patients. All the patients received alfentanil 0.01 mg/kg i.v. at the start of anaesthesia and were randomized into two groups. Group R (regional, 31 patients): midazolam 0.1 mg/kg i.v. and paracervical blockade with 2 x 10 ml of mepivacaine 20 mg/ml + adrenaline 0.005 mg/ml. Group G (general, 28 patients): propofol 2.0 mg/kg i.v. induction and 75% nitrous oxide in oxygen spontaneous respiration. In 10 patients from the R-group venous blood samples were taken regularly for 30 min for serum concentration measurements (gas chromatography) of mepivacaine. Pain during induction of anaesthesia was remembered by 17% in Group G and 4% in Group R, whereas 8% in Group R remembered pain during the procedure compared with none in Group G. Of the patients in Group G, 25% had apnoea compared with none in Group R. In Group R the patients slept for 2.5 +/- 3.8 min (mean +/- s.d.) after induction compared with 12 +/- 4.0 min in Group G. Except for a better p-deletion score 30 min after the procedure in Group G, there was no difference in recovery function between the groups. Of the patients in Group G, 67% experienced postoperative pain compared with 23% in Group R. Maximum serum mepivacaine concentration (Group R) was reached at 15-30 min, range 1.5-5 micrograms/ml.
Raeder
J C
JC
Department of Anaesthesia, Baerum Sykehus, Norway.
D000028:Abortion, Induced; D000328:Adult; D015760:Alfentanil; D000556:Ambulatory Surgical Procedures; D000771:Anesthesia, Intravenous; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D003071:Cognition; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008568:Memory; D008619:Mepivacaine / Q000097:blood; D008874:Midazolam; D010149:Postoperative Pain / Q000209:etiology; D011229:Preanesthetic Medication; D011247:Pregnancy; D015742:Propofol; D011446:Prospective Studies; D013997:Time Factors; D014851:Wakefulness
D015760:Alfentanil; D008619:Mepivacaine; D008874:Midazolam; D015742:Propofol