Propofol auto-co-induction as an alternative to midazolam co-induction for ambulatory surgery.
We propose the use of an intravenous propofol/propofol auto-co-induction technique as an alternative to propofol/midazolam for induction of anaesthesia. We have studied 54 unpremedicated ASA 1 or 2 patients undergoing day-stay anaesthesia for minor orthopaedic surgery. All received 10 micrograms.kg-1 or alfentanil before induction, followed by either midazolam 0.05 mg.kg-1, propofol 0.4 mg.kg-1 or saline, and 2 min later, a propofol infusion at a rate of 50 mg.kg-1.h-1 until loss of eyelash reflex. We compared pre- and postinduction haemodynamic changes, complications at insertion of a laryngeal mask airway and recovery from anaesthesia in the three groups. Both co-induction techniques showed less postinduction hypotension and significant reduction of the total induction dose of propofol when compared to the control group. In the propofol/propofol group there was a decreased incidence of apnoea during induction of anaesthesia. These patients were discharged from hospital 2 h after the end of anaesthesia whereas patients in the midazolam/propofol group were discharged after 2 1/2 h (p < 0.001).
Djaiani
G
G
Department of Anaesthetics, Morriston Hospital, Swansea, UK.
Ribes-Pastor
M P
MP
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D019162:Anesthetics, Combined / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D008875:Middle Aged; D019637:Orthopedic Procedures; D015742:Propofol / Q000494:pharmacology*
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol