[A comparison of the course of anesthesia using a bolus application of propofol, methohexital or etomidate as hypnotics and alfentanil analgesia]

Author(s): Ensink FB, Schwabe K, Bittrich B, Kuhn U, Weingarten J, Schenk HD

Affiliation(s): Institut fur Anaesthesiologie und Operative Intensivmedizin, Evangelisches Krankenhaus Gottingen-Weende e.V.

Publication date & source: 1989-07, Anaesthesist., 38(7):333-40.

Publication type: Clinical Trial; Controlled Clinical Trial; Randomized Controlled Trial

The suitability of the analgesic-hypnotic combination alfentanil-propofol in nitrous oxide-oxygen IPPB for short-term and outpatient anesthesia was studied in 50 patients of ASA risk groups I and II. This study appeared pertinent since the two substances have the shortest half-lives of their respective classes of medication. For comparison, two groups of similar size were treated with the well-established combinations alfentanil-methohexital and alfentanil-etomidate. During the entire intra- and postoperative periods the circulatory parameters were frequently monitored as was the continuous recording of the compressed spectral array in the EEG. Thirty minutes after extubation three modified tests of recovery were carried out that were compared to the preoperative results. For a subjective evaluation, a multiple choice questionnaire was answered by each patient after the recovery tests. The mean duration of anaesthesia in all three groups was 1 h. All three combinations were found to be agreeable to the patients with the best results in the propofol group. These patients also showed the most rapid recovery; consequently, the combination of alfentanil and propofol would appear to be especially suitable for outpatients. For the induction of anesthesia alfentanil was administered in a dosage of 30 micrograms/kg body weight in combination with propofol 1.5 mg/kg, methohexital 1.0 mg/kg or etomidate 0.2 mg/kg. For anesthesia maintenance the following mean dosages were found to be suitable: Alfentanil 1 microgram/kg/min, propofol 46 micrograms/kg/min, methohexital 24 micrograms/kg/min, and etomidate 4 micrograms/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)