Continuous intravenous propofol with nitrous oxide for ocular surgery. A comparison with etomidate, alfentanil, nitrous oxide and isoflurane.
Propofol, administered intravenously for induction and as a continuous maintenance anaesthetic with nitrous oxide, was compared, in a group of elderly patients scheduled for ophthalmic surgery, with an anaesthetic technique (etomidate, alfentanil, nitrous oxide and isoflurane) specifically chosen to be haemodynamically stable and evanescent in action. Both techniques resulted in similar effects on blood pressure after induction, intubation and surgical incision, but propofol did not prevent increases in heart rate as effectively at these times. Furthermore, during maintenance anaesthesia, cardiovascular stability and anaesthetic depth were more easily achieved in the group where etomidate, alfentanil and isoflurane were used. Propofol decreased intra-ocular pressure after intubation, while in both groups recovery was rapid with no significant complications. A subgroup of patients receiving alpha-methyldopa had significantly longer post-anaesthetic recovery times.
Mets
B
B
Department of Anaesthesia, Groote Schuur Hospital.
Salmon
J F
JF
James
M F
MF
D000368:Aged; D000369:Aged, 80 and over; D015760:Alfentanil / Q000008:administration & dosage; D000771:Anesthesia, Intravenous / Q000379:methods*; D005045:Etomidate / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage*; D013508:Ophthalmologic Surgical Procedures; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*
D015760:Alfentanil; D007530:Isoflurane; D009609:Nitrous Oxide; D015742:Propofol; D005045:Etomidate