[Use of Diprivan in ophthalmology].
Propofol may be used in several ways: As an induction agent for general anaesthesia. Maintenance is ensured by a halogenated anaesthetic, an opioid and a muscle relaxant, in an intubated and ventilated patient. It is interesting to administer propofol simply for induction, because of the rapid recovery. As the main anaesthetic agent, ensuring induction and maintenance of anaesthesia, combined with an opioid and a muscle relaxant, particularly during total intravenous anaesthesia. The patient is intubated and ventilated mechanically. To complement retrobulbar or peribulbar anaesthesia, given just before administration of the local anaesthetic, to produce amnesia of the injection. Small doses of propofol are then sufficient (0.3 to 1.5 mg.kg-1). Some authors continue to administer propofol throughout the procedure, with the patient breathing spontaneously. In young adults, a dosage regimen of 2.5 mg.kg-1 for induction, followed by an infusion or preferably a syringe pump administration of 6 to 12 mg-1.kg-1, ensures calm induction and rapid recovery. A gradual decrease in the administration rate: 10 mg.kg-1.h-1 for 10 min. 8 mg.kg-1.h-1 for 10 min, then 6 mg.kg-1.h-1, has been suggested. In the elderly, over 60 years of age, reducing the dose of propofol by 50% limits haemodynamic effects. Prior vascular fluid loading with 5 to 10mL.kg-1 is preferred by some authors. Administration of 0.5 to 1.5 mg.kg-1 by slow injection or titration, while monitoring haemodynamic effects, decreases side effects. Maintenance of anaesthesia with a dose range of 3 to 9 mg.kg-1.h-1 of propofol, according to surgical stimuli and haemodynamic stability, is recommended. In children between 3 and 10 years of age, larger doses are required, over 3 mg.kg-1 in 20 seconds, virtually without excitatory phenomena. In the absence of premedication, a dose of 4 mg.kg-1 is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)
Julia
B
B
Département d'Anesthésie-Réanimation, CHU Purpan, Toulouse.
D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000379:methods*; D005128:Eye Diseases / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D015742:Propofol / Q000494:pharmacology; D012024:Reflex, Oculocardiac / Q000187:drug effects
D015742:Propofol
Utilisation du Diprivan en ophtalmologie.