title: Comparison of midazolam and propofol in combination with alfentanil for total intravenous anesthesia.
abstract: Hemodynamic function during induction of anesthesia, the alfentanil and naloxone requirements, and the speed of recovery from total intravenous anesthesia with alfentanil/midazolam (group M, n = 10) or alfentanil/propofol (group P, n = 10) were compared in patients undergoing lower limb surgery. Twenty patients were randomly assigned to receive either 2 mg/kg propofol in 5 min followed by 9 mg.kg-1.h-1 for 30 min and 4.5 mg.kg-1.h-1 until skin closure, or 0.42 mg/kg midazolam in 5 min followed by 0.125 mg.kg-1.h-1 until skin closure. Simultaneously, a variable-rate infusion of alfentanil was given. Patients were ventilated with 30% oxygen in air. In both groups blood pressure and heart rate decreased significantly (P less than 0.02) and to a similar extent during induction. The total dose of alfentanil was similar in both groups. No patient in group P and nine patients in group M needed naloxone (average dose 130 +/- 70 micrograms, P less than 0.001). Recovery, as judged by psychomotor tests (90% score was reached at 1 h in the P group and at about 4 h in the M group, P less than 0.001), sedative scores, and orientation in time and place, was shorter in group P than in group M. The conclusion is reached that propofol is superior to midazolam in total intravenous anesthesia with alfentanil.
authors.affiliation: Department of Anesthesiology, Leiden University Hospital, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Vuyk
authors.forename: P J
authors.initials: PJ
authors.lastname: Hennis
authors.forename: A G
authors.initials: AG
authors.lastname: Burm
authors.forename: J W
authors.initials: JW
authors.lastname: de Voogt
authors.forename: J
authors.initials: J
authors.lastname: Spierdijk
mesh_terms: D000328:Adult; D015760:Alfentanil; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D001842:Bone and Bones / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam; D015742:Propofol
chemical_list: D015760:Alfentanil; D008874:Midazolam; D015742:Propofol