Propofol infusion technique for outpatient general anesthesia.
OBJECTIVE
The purpose was to evaluate the suitability of a continuous propofol infusion in combination with alfentanil for outpatient general anesthesia in an oral and maxillofacial surgery practice.


METHODS
Twenty-seven ASA 1 patients were selected to undergo oral and maxillofacial surgery outpatient procedures of short duration. Induction of anesthesia was accomplished with 1 mg/kg intravenous (i.v.) propofol and 10 micrograms/kg i.v. alfentanil. Local anesthesia was administered. General anesthesia was maintained with a continuous infusion of 150 micrograms/kg/min of propofol. Various physical and psychomotor responses were recorded during induction, maintenance, emergence, and recovery.


RESULTS
Anesthesia was successfully induced in all patients with single, slowly titrated, bolus doses of 1 mg/kg of propofol and 10 micrograms/kg of alfentanil. Induction of general anesthesia occurred in less than 1 minute in all cases and no excitatory phenomena, tremor, or hypertonus were observed. Maintenance of anesthesia was adequately accomplished and cardiovascular parameters remained within acceptable limits throughout the procedure. The average length of surgery was 22 minutes. Movement to surgical stimulus was minimal and easily managed with additional local anesthetic and/or a 10-mg bolus of propofol. Time to eye opening was approximately 5 minutes from the discontinuation of the propofol infusion. No emergence phenomena were observed. All patients were ready for discharge with baseline psychomotor activity within 30 minutes following the end of the procedure. The average total dose of propofol was 350 mg and the average dose of alfentanil was 750 micrograms.


CONCLUSIONS
This anesthetic technique has numerous advantages with minimal side effects, and should be considered for routine use for outpatient general anesthesia in oral and maxillofacial surgery.
Candelaria
L M
LM
Department of Oral and Maxillofacial Surgery, University of Tennessee, Memphis 38163.
Smith
R K
RK
D000293:Adolescent; D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage / Q000191:economics; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D000771:Anesthesia, Intravenous; D001794:Blood Pressure; D016527:Drug Costs; D006339:Heart Rate; D006801:Humans; D007262:Infusions, Intravenous; D016343:Monitoring, Intraoperative; D009609:Nitrous Oxide; D015742:Propofol / Q000008:administration & dosage* / Q000191:economics
D015760:Alfentanil; D009609:Nitrous Oxide; D015742:Propofol