The differential cost of anesthesia and recovery with propofol-nitrous oxide anesthesia versus thiopental sodium-isoflurane-nitrous oxide anesthesia.
OBJECTIVE
To assess the recovery room profile of propofol in outpatient anesthesia and to compare it to the profile of a standard technique.


METHODS
A comparative, randomized, double-blind, third-party open study.


METHODS
Ambulatory Surgery Center at The Emory Clinic.


METHODS
Ninety-nine ASA physical status I, II, or III nonpregnant female patients who had been diagnosed as needing breast biopsies.


METHODS
All patients were given 1 microgram/kg of fentanyl prior to induction. Those in the propofol group were induced with 2.0 to 2.5 mg/kg of propofol and maintained with a 100 to 200 microgram/kg/min infusion of propofol with nitrous oxide (N2O) in oxygen (O2). In the thiopental sodium-isoflurane group, patients were induced with 4.0 to 5.0 mg/kg of thiopental sodium and maintained with isoflurane and N2O in O2.


RESULTS
Recovery from anesthesia was assessed by an evaluator who was unaware of the anesthetic technique used for each patient. Immediate recovery time was measured in terms of awakening, response to verbal command, and orientation to time and place. A brief postoperative follow-up questionnaire was completed to assess the patients' subjective feelings regarding their ability to eat, concentrate, and resume normal activities. In the thiopental sodium-isoflurane group, 15 of 50 patients (30%) had nausea and vomiting, but in the propofol group, only 4 of 49 patients (8.1%) had nausea and vomiting (p less than 0.01). The latter group resumed normal activity (i.e., reading and watching television) 7.93 +/- 0.76 hours postanesthesia, whereas the thiopental sodium-isoflurane group resumed normal activity 17.02 +/- 1.21 hours postanesthesia (p less than 0.001). Patients in the propofol group returned to work in an average of 1.5 +/- 0.09 days, compared with 2.0 +/- 0.09 days for the thiopental sodium-isoflurane group (p less than 0.001).


CONCLUSIONS
The propofol group needed less nursing care and returned to more productive activity earlier than did the thiopental sodium-isoflurane group.
Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA.
Y F
YF
Sung
N
N
Reiss
T
T
Tillette
D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007530:Isoflurane; D009609:Nitrous Oxide; D015742:Propofol; D013874:Thiopental
D007530:Isoflurane; D013874:Thiopental; D009609:Nitrous Oxide; D015742:Propofol