Propofol and alfentanil total intravenous anaesthesia: a comparison of techniques for major thoracic surgery.
BACKGROUND
Previous work has highlighted the disadvantages of propofol as a sole agent for total intravenous anaesthesia (TIVA). This randomised study investigated three combinations of propofol and alfentanil as TIVA for major thoracic surgery.


METHODS
In 73 patients undergoing elective thoracic surgery, anaesthesia was conducted either with sodium thiopentone induction and inhalational maintenance (incorporating isoflurane) or with TIVA using propofol with alfentanil (by infusion at one of two rates or in incremental doses). Vital signs and recovery characteristics were recorded.


RESULTS
There were no significant differences in heart rate or blood pressure between groups during either induction or maintenance. Depth of anaesthesia was controlled satisfactorily in all groups. Recovery characteristics were similar between treatment groups, although there was a trend towards earlier orientation in the group which received the highest infusion rate of alfentanil.


CONCLUSIONS
Continuous infusions of propofol and alfentanil provide safe and reliable TIVA for major thoracic surgery. TIVA was found to be a satisfactory technique in more elderly patients than previously described. The higher of the two alfentanil infusion rates may result in a better combination of propofol and alfentanil with respect to recovery times than the lower.
Trinder
T J
TJ
Department of Clinical Anaesthesia, Royal Hospitals, Belfast, Northern Ireland, UK.
Johnston
J R
JR
Lowry
K G
KG
Phillips
A S
AS
Cosgrove
J
J
D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage*; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures
D018686:Anesthetics, Intravenous; D015760:Alfentanil; D015742:Propofol