Propofol dosage achieving spontaneous breathing during balanced regional anesthesia with the laryngeal mask airway.
OBJECTIVE
To assess an anesthetic technique achieving spontaneous breathing through the laryngeal mask airway (LMA) during combined epidural block and propofol anesthesia.


METHODS
Prospective, consecutive case series study.


METHODS
Operating room at a general hospital.


METHODS
112 ASA physical status I and II adult surgery patients; 32 patients for lower extremity surgery are enrolled into study 1, and 30 patients for lower extremity surgery and 50 patients for lower abdominal gynecology surgery are enrolled into study 2.


METHODS
In study 1, patients were given 1.5 to 2.0 mg/kg followed by a 3 mg/kg/h of infusion of propofol, after epidural block, and they were fitted with the LMA. Thirty minutes after induction, the dose of propofol was increased to 4, 5, 6, and 7 mg/kg/h every 15 minutes. In study 2, the patients were given 1.5 to 2.0 mg/kg and 5 mg/kg/h of propofol and the LMA insertion, after epidural block.


RESULTS
PaO(2)/FIO(2), PaCO(2), tidal volume or respiratory rate, blood pressure, heart rate, and eye opening and motor response scales in conformity with Glasgow coma scale were recorded. Study 1 suggested an induction dose of 1.5 to 2.0 mg/kg and an infusion of 5 mg/kg/h as an appropriate dose to preserve spontaneous breathing with the LMA and to maintain reasonable depth of anesthesia. Study 2 showed that respiratory and circulatory conditions, depth of anesthesia, and other data related to anesthesia were clinically acceptable.


CONCLUSIONS
The best infusion dose of propofol to achieve spontaneous breathing with the LMA seems to be 5 mg/kg/h, and the present balanced regional anesthesia with the LMA, using propofol infusion at 1.5 to 2.0 mg/kg and 5 mg/kg/h combined with epidural block, may be useful in clinical practice for lower extremity and lower abdominal gynecologic operations.
Iwama
H
H
Department of Anesthesiology, Central Aizu General Hospital, Aizuwakamatsu, Japan.
Nakane
M
M
Ohmori
S
S
Kato
M
M
Kaneko
T
T
Iseki
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002245:Carbon Dioxide / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008619:Mepivacaine / Q000494:pharmacology; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects*
D018686:Anesthetics, Intravenous; D002245:Carbon Dioxide; D008619:Mepivacaine; D010100:Oxygen; D015742:Propofol