Propofol-based anesthesia as compared with standard anesthetic techniques for middle ear surgery.
OBJECTIVE
To determine whether a totally intravenous technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery.


METHODS
Prospective randomized study.


METHODS
Inpatient otolaryngology service at a university medical center.


METHODS
Physical status 1 and 2 nonobese patients with no significant history of diabetes, chronic cholecystitis, neuropathy, or neuromuscular disorders that could produce delayed gastric emptying. One hundred two patients were admitted to the study and randomly divided into three equal groups.


METHODS
Intravenous thiopental, 5 mg/kg, was administered for induction of anesthesia followed by 60% air/O2 with isoflurane, 1% to 2% end tidal, for maintenance anesthesia (group 1). The same anesthetic with the addition of droperidol, 25 micrograms/kg, was given after induction (group 2). Propofol, 2 mg/kg, was administered intravenously for induction of anesthesia and followed by propofol, 50 to 250 micrograms/kg/min, for maintenance anesthesia. All groups received fentanyl, 3 micrograms/kg intravenously, after induction.


RESULTS
Surgical duration, induction, maintenance, and total anesthesia times were recorded together with eye opening and extubation. Intergroup comparisons of postoperative nausea, vomiting, and pain, and recovery scores, we made by use of the Steward system. Patients receiving propofol, compared with the isoflurane-only group, had significantly less nausea (4/34 vs 12/34 patients, respectively; p < 0.05) and as vomiting (2/34 vs 8/34 patients, respectively; p < 0.05). Immediate recovery scores were significantly better for propofol compared with the isoflurane-droperidol group. Recovery scores at 30 minutes were also faster with propofol compared with isoflurane or isoflurane-droperidol (5.7 +/- 0.1 vs 5.1 +/- 0.2 and 5.2 +/- 0.2; p < 0.05).
Department of Anesthesiology, Loyola University Medical Center, Maywood, IL 60153.
W S
WS
Jellish
J P
JP
Leonetti
J R
JR
Murdoch
S
S
Fowles
D000328:Adult; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D004329:Droperidol / Q000008:administration & dosage; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D013874:Thiopental / Q000008:administration & dosage; D014839:Vomiting / Q000209:etiology
D007530:Isoflurane; D013874:Thiopental; D004329:Droperidol; D005283:Fentanyl; D015742:Propofol