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PubMed1993

Comparison of Telazol, Telazol-ketamine, Telazol-xylazine, and Telazol-ketamine-xylazine as chemical restraint and anesthetic induction combination in swine.

The use of Telazol (T, tiletamine and zolazepam, 4.4 mg T/kg) alone, Telazol-ketamine (TK, 4.4 mg T/kg and 2.2 mg K/kg), Telazol-xylazine (TX, 4.4 mg T/kg, 2.2 mg X/kg), and Telazol-ketamine-xylazine (TKX, 4.4 mg T/kg, 2.2 mg K/kg, and 2.2 mg X/kg) as chemical restraint and anesthetic induction combination was compared in pigs. Forty mixed-breed healthy pigs (24.4 +/- 5.6 kg, mean +/- SD) were randomly assigned to the four treatment groups (T, TK, TX, TKX) with 10 pigs in each group. All the anesthetics were premixed by adding sterile water, ketamine, xylazine, or xylazine and ketamine directly into the Telazol vial and given as a single intramuscular injection. All four anesthetic combinations induced a rapid onset of sternal recumbency within 1.76 +/- 1.0 minutes and lateral recumbency within 3.02 +/- 2.2 minutes in pigs after intramuscular injection; there was no significant difference among treatments. The combinations TX and TKX induced analgesia (as evident by a lack of response to needle prick in the middle portion of the pinna and flank regions) duration of 29.0 +/- 11.0 and 36.0 +/- 12.2 minutes, respectively, and ability to tolerate tracheal intubation (as evident by lack of coughing and chewing response to a laryngoscope) for a period of 34.0 +/- 8.4 and 39.0 +/- 9.9 minutes, respectively. The combinations T and TK did not induce analgesia nor conditions suitable for intubation. Duration of lateral recumbency was 29.9 +/- 10, 33.1 +/- 6.9, 52.2 +/- 6.9, and 61.5 +/- 10.7 minutes in T-, TK-, TX-, and TKX-treated pigs, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia Recovery Period↗
PubMed1994

Auditory steady-state response, upper facial EMG, EEG and heart rate as predictors of movement during isoflurane-nitrous oxide anaesthesia.

We have studied the relationship between patient movement and changes in the auditory steady-state evoked potential, upper facial muscle electromyogram (FEMG), electroencephalographic-zero crossing frequency (EEG-ZCF) and heart rate during emergence from anaesthesia. Twelve healthy patients underwent surgery during stable isoflurane-nitrous oxide-oxygen anaesthesia without neuromuscular block. After skin closure, anaesthesia was discontinued abruptly while mechanical ventilation was continued until the patient moved. The magnitude of change in each physiological signal was evaluated in decibels (dB). Both the auditory steady state evoked potential and FEMG showed significant increases in amplitude during the last 5-min period before movement (6.1 and 10.7 dB, respectively). EEG-ZCF increased rapidly after anaesthesia was discontinued (2.5 dB) but there was no further increase in activity before movement. Heart rate did not change before movement. The use of the decibel transformation offers a promising method of displaying and interpreting changes in physiological variables during anaesthesia.

Adult↗
PubMed2006

Malignant hyperthermia and day stay surgery.

Patients who are malignant hyperthermia susceptible are often admitted overnight for observation, even after minor surgery. They may be declined care in a stand-alone day stay unit. This prospective audit set out to investigate whether patients susceptible to malignant hyperthermia can be safely treated as day stay patients. The audit was conducted for four years from late 2000. All patients who were known to be susceptible to malignant hyperthermia, and their untested relatives, who received day stay anaesthesia were included in the audit. Malignant hyperthermia status, age, duration of anaesthesia, anaesthetic technique, type of procedure, intraoperative and postanaesthesia care unit observations and complications were recorded. All patients received a trigger-free anaesthetic technique. Detailed postanaesthesia care unit monitoring was undertaken and patients were observed for two and a half hours postoperatively. Seventy-two patients were included in the audit. General anaesthesia was administered to 85% and regional to 15%. Only minor complications arose in the postoperative period, and none suggested a malignant hyperthermia reaction. Postanaesthesia care unit nursing staff contacted 49 (68%) of the patients the following day, and there was no evidence of malignant hyperthermia reactions. This audit suggests that malignant hyperthermia susceptible patients can be safely managed as day stay patients in appropriate facilities, with appropriate postoperative care.

Adolescent↗
PubMedDate not supplied

[The early postanesthetic period in children].

Forty-one children aged 4 to 15 years, who had been operated on for varicocele and hernias at various sites, were examined. Central hemodynamics, and the level of sedation and pain were assessed. Studies were performed in 2 groups of patients: 1) those who received anesthesia with ketamine in combination with propofol and 2) those who had inhalational-mask anesthesia using phtorotan in combination with nitrous oxide. They indicated that the patients more promptly emerged from phtorotan anesthesia; however, they require preventive analgesia.

Adolescent↗
PubMed1998

[Efficacy of epidural analgesia in minimally invasive direct coronary artery bypass surgery].

Minimally invasive direct coronary artery bypass surgery (MIDCAB), coronary bypass grafting with small thoracotomy using no cardiopulmonary bypass (CPB), became popular recently. To attenuate perioperative stress-response, we used epidural analgesia (EPI) with general anesthesia for MIDCAB operation. In this study, we compared retrospectively 11 cases of MIDCAB managed with EPI [ED (+)], and 14 cases of MIDCAB anesthetized without using EPI [ED (-)], concerning extubation time, ICU stay, hospital stay and perioperative complications. The mean time from cessation of general anesthesia to extubation was significantly shorter in ED (+) patients (0.5 hours) when compared to ED (-) patients (18.2 hours). Mean periods of ICU stay and hospital stay were, also, shorter in ED (+) patients (2.1 days, 30.5 days, respectively) when compared to ED (-) (4.3 days, 45.1 days, respectively) patients. We experienced ventricular tachycardia in three patients of ED (-). No major complication occurred in ED (+) patients. These results suggest that EPI shortened extubation time, ICU and hospital stay for MIDCAB patients.

Aged↗
PubMed1992

[Cognitive and psychomotor performance following isoflurane, midazolam/alfentanil and propofol anesthesia. A comparative study].

Mental and psychomotor abilities are impaired to varying degrees after general anaesthesia. This has important implications for the time over which patients are monitored in the recovery room and for the discharge of outpatients after day surgery. The present study was undertaken to compare recovery and mental and psychomotor skills in the first 60 min following general anaesthesia with isoflurane, midazolam/alfentanil and propofol. METHODS. A total of 45 patients undergoing microsurgical lumbar nucleotomy were randomized to three study groups. Group 1 (n = 15): anaesthesia was induced with thiopentone and maintained with isoflurane; group 2 (n = 15): anaesthesia was induced with midazolam and maintained with alfentanil; group 3 (n = 15): anaesthesia was induced and maintained with propofol. Vecuronium was used for muscle relaxation and the lungs were ventilated with a mixture of 66% nitrous oxide in oxygen. The following were checked 15, 30, 45, and 60 min after extubation: choice reaction times and critical flicker fusion for psychomotor testing; the maze test and a modification of the ball-bearing test for discrimination of motor and mental activities; and short- and long-term memory. RESULTS. Immediate recovery did not differ in the three different groups. In all patients psychomotor function was impaired compared with baseline for more than 60 min after general anaesthesia. However, impairment was significantly less pronounced after propofol, and recovery to preanaesthesia values was faster following propofol than after midazolam/alfentanil, and slowest after isoflurane-anaesthesia (Figs. 1, 2). The flicker fusion frequency, a very sensitive parameter for the persisting effects of anaesthetics, was significantly higher following propofol anaesthesia and remained so throughout the entire study period (Fig. 3). By 30 min after extubation, short-term memory was already normal in patients who had undergone propofol anaesthesia, and a statistically significant difference from the midazolam/alfentanil and isoflurane anaesthesia groups was obvious throughout the entire study period. However, no differences in long-term memory were found. At 30 min after propofol anaesthesia all patients were able to perform the ball-bearing test, as against 13 patients following midazolam/alfentanil and 10 patients following isoflurane (Table 3). The maze test was mostly impaired after midazolam/alfentanil anaesthesia. Patients who underwent isoflurane anaesthesia needed the same time for the maze test at 60 min afterwards propofol patients needed after 30 min (Table 2). Side effects, e.g., nausea, vomiting, and double vision, were observed significantly more often in groups 1 and 2 (Table 4). DISCUSSION AND CONCLUSION. The results indicate that in operations of approximately 90 min duration the return of motor and mental abilities is faster following propofol anaesthesia. At 30 min after extubation following propofol anaesthesia patients had test results that allow their transfer from the recovery room, while it took 60 min for patients in the two other groups to reach the same levels of motor and mental function. This is important for the duration of monitoring in the recovery room and, especially, for day case anaesthesia.

Adult↗
PubMed2003

[Clinical study on applying brainstem auditory evoked potential to monitor anesthesia depth and awaken in children].

OBJECTIVES: To study applying auditory brainstem reaction (ABR) to monitor the general anesthesia depth and awaken degree in children as an objective guide. METHODS: Forty-five infant or children patients, American Society of Anesthesiologists(ASA) graded I-II, with normal audition, were selected and divided into 3 groups (15 cases per group) to receive propofal venous anesthesia, fentanyl venous anesthesia, or isoflurane anesthesia, respectively. During anesthesia, peak latencies (PL) of I, III, V wave, and interpeak latencies (IPL) of I-III, III-V, I-V were monitored and recorded after short sound stimulation of 90 db which accumulated 1,000 times with Madsen. The changing of PL and IPL with time passing and anesthesia dosage was studied to discuss the feature of ABR in each anesthesia procedure as above. RESULTS: There is a significant positive correlation between PL and IPL of ABR waves as above and the dosage of propofol or the concentration of isoflurane. The dosage or the concentration increased, and PL and IPL prolonged. It is important of PL of wave I to reflect anesthesia degree. It is wave V with the best stability and correlation to monitor anesthesia degree. After anesthesia period or patients almost awaken, PL and IPL of some ABR waves were still more than normal values, which is detention reaction. For the fentanyl anesthesia, ABR is not sensible enough, i.e. has little correlation. CONCLUSION: The changing of PL and IPL of ABR waves could conclude anesthesia degree in children and be treated as reference of whether awaken or not in some certain, but have possibility of detention reaction.

Anesthesia Recovery Period↗
PubMed2000

Effects of peribulbar bupivacaine as an adjunct to general anaesthesia on peri-operative outcome following retinal detachment surgery.

Sixty premedicated, ASA physical status I or II patients weighing > 25 kg scheduled for elective retinal detachment repair were randomly assigned to receive either peribulbar block with 10 ml of 0.25% bupivacaine (block group) or intravenous morphine 150 microg.kg-1 (morphine group), prior to the induction of general anaesthesia (n = 30 in each group). Patients were evaluated for intra-operative oculocardiac reflex, peri-operative pain relief, recovery from anaesthesia and postoperative nausea and vomiting. Apart from significantly reducing the incidence of oculocardiac reflex (30% vs. 70%, p = 0.0019), peribulbar bupivacaine also attenuated the severity of the reflex. Postoperative pain relief was superior in the block group. More block group patients had the maximum recovery score in the immediate postoperative period (80% vs. 27%, p < 0. 0001) and they achieved complete recovery significantly faster than the morphine group (17.3 (14.7) min vs. 66.7 (29.7) min, p < 0.0001). The incidence (40% vs. 77%, p = 0.004) and severity of postoperative nausea and vomiting were significantly less in the block group. In summary, peribulbar bupivacaine, when administered together with general anaesthesia, attenuated oculocardiac reflex, provided comparable intra-operative and superior postoperative analgesia, resulted in significantly earlier and better recovery from anaesthesia, and significantly reduced the incidence and severity of postoperative nausea and vomiting.

Adolescent↗
PubMed1995

Total i.v. anaesthesia with propofol and the laryngeal mask for orthopaedic surgery.

One hundred ASA I orthopaedic surgical patients (four randomized groups) were anaesthetized using continuous propofol and intermittent fentanyl (TIVA), with controlled ventilation via a tracheal tube in groups 1 and 2, and a laryngeal mask airway (LMA) in groups 3 and 4. Neuromuscular blockers were used in groups 1 and 3 only. There were no significant differences between groups in total anaesthetic requirements, as assessed by cardiovascular variables and movement. Coughing interfered with surgery and made controlled ventilation difficult to manage. In contrast, movement not associated with coughing did not impair surgery or ventilation. Patients in group 2 (tracheal tube, no neuromuscular blocker) required more interventions for coughing than the other groups, while patients in group 4 (LMA, no neuromuscular blocker) needed more boluses for movement than groups 1 and 3. Groups 1 and 2 (tracheal tube) had significantly higher heart rates and mean arterial pressures than groups 3 and 4 for varying periods up to 5 min after insertion of the airway management device. There was no correlation between mean arterial pressure and plasma concentrations of catecholamines related to insertion of either the tracheal tube or LMA. The LMA was found to be a highly effective device for controlled ventilation in TIVA and easier to manage than the tracheal tube in the absence of neuromuscular blockers.

Adolescent↗
PubMed1996

Patient-controlled premedication by i.v. midazolam for ambulatory surgery.

Applying the principle and equipment of patient-controlled analgesia, this double-blind randomised study was designed to determine the premedication dose of midazolam and to provide information about the need for preoperative anxiety control. The effects of patient-controlled premedication by i.v. midazolam were compared to those of a 1-hour i.v. infusion of a fixed dose of 4 mg. Two groups of 25 patients were studied prior to ambulatory surgery. Using a visual analogue scale graded from 0 (no anxiety) to 100, anxiety and short-term memory as well as vital signs, vigilance, cognition and orientation were assessed before premedication and then every 20 min until admission to the operating room. In both groups, 40% of the patients were free of anxiety before premedication. Sixty-four percent of patients in the self-pre-medicated group never used the pump. The dose of midazolam was only 0.7 0.2 mg (mean SD) in this group taken as a whole, 0.7, 1.1 mg (mean SD) in the 8 patients who had an anxiety score at least equal to 50 before premedication, and 1.7 0.3 mg (mean SD) in the 9 patients who chose to push the button of the patient-controlled device. Anxiety and short-term memory scores decreased significantly and similarly in the self-premedicated group and in the fixed-dose group. For similar intraoperative anaesthetic requirements, time from the end of anaesthesia for determining whether a patient was ready for admission to the postrecovery lounge was shorter in the self-premedicated group (26 +/- 8 min vs 32 +/- 8 min; mean +/- SD. Reduced doses of midazolam self-administered via a patient-controlled device can result in a relaxed preoperative period and amnesia in ambulatory surgery patients. However, the level of anxiety before premedication was low, which calls into question the legitimacy of the patient-controlled premedication in this kind of population. The expense of the pump was not justified by the small number of patients using it, probably because they were worried by the technical nature and the invasiveness of this technique.

Adult↗
PubMedDate not supplied

[Preventive analgesia and early postoperative period in ambulatory orthopedic surgeries in children].

The purpose of the case study was to compare the adequacy of anesthetic management and the specificity of the early postoperative course with preventive analgesia (group 1) and without it (group 2). Preventive analgesia comprised diclofenac, 50-75 mg/kg in intramuscular injections made 1 h before surgery, and microdoses of ketamine, 1.0 mg/kg in intramuscular injections 0.3 mg/kg in intravenous injections as a component of premedication. In as far as the hemodynamic course is concerned, both types of anesthesia were adequate. The main differences were registered in the assessment of the early postoperative period. An earlier awakening was observed in group 1, which we attributed to a more valuable antinociceptive protection and to lower doses of ketamine (group 1--3.2 mg/kg; group 2--4.3 mg/kg). According to the results the preventive analgesia method reduces significantly the postoperative pain and anxiety, which makes the administration of additional analgetics advisable and cuts the child's stay in one-day hospital.

Adolescent↗
PubMed1998

[The problems of ambulatory anesthesiology].

Prospects of the development of ambulatory anesthesiology are greatly dependent on understanding its problems caused by the specific character of work of the ambulatory polyclinical institutions. The most important of them is responsibility for safety of the patients during general anesthesia and after it as well as comfort feelings of the patients in the nearest postoperative period. The solution of these problems is related not only with qualification of anesthesiologists but also with the adequate, corresponding to the present-day level of the material technical supply of their work. Of special importance are the "postnarcosis" wards, ability of the personnel to evaluate the psychophysiological state of the patients and correspondence of their life conditions to the requirements of ambulatory anesthesiology.

Ambulatory Surgical Procedures↗
PubMed2004

Assessment of cardiovascular parameters during dental procedures under the effect of benzodiazepines: a double blind study.

The purpose of this study was to evaluate cardiovascular parameters during dental procedures: systolic, diastolic, and mean blood pressures, and heart rate. Nineteen healthy normotensive patients (18-56 years of age) received restorative treatment on three maxillary molars. The patients were continuously monitored by a non-invasive automatic monitor for blood pressure and heart rate during the pre-, trans-, and post-operative periods at the following stages: 15 min prior to anesthesia; during topical anesthesia; during infiltrative anesthesia; for 5 minutes immediately after; during cavity preparation; during restorative procedure; for 10 min after completion. Patients were divided into three groups: A (without pre-medication), B (preceded by 10 mg diazepam), and C (preceded by placebo). All patients received infiltrative anesthesia containing 1.8 mL of 2% lidocaine (36 mg) with epinephrine 1:100,000 (18 microg). There were no changes in the parameters during the clinical procedures. When groups were compared, there were significant differences in diastolic arterial pressures during anesthesia.

Adolescent↗
PubMed1988

Continuous electromyography for monitoring depth of anesthesia.

Utilizing a randomized, controlled study design, the clinical utility of monitoring spontaneous electromyography during methohexital anesthesia was evaluated for short outpatient gynecologic procedures. In the experimental group (n = 20), the anesthesiologist used conventional monitors as well as the Datex ABM device for determining the maintenance anesthetic requirement. The control group (n = 20) was monitored in an identical fashion, but the video monitor screen was turned off during the operation. The methohexital maintenance requirement was nonsignificantly decreased (5.0 +/- 1.2 vs 5.6 +/- 1.8 mg/min) in the experimental group. Adequacy of anesthesia (as determined by cardiorespiratory stability and the absence of purposeful movement during the maintenance period) did not differ between the two study groups. Although the awakening time for the experimental group (2.9 +/- 1.9 minutes) was decreased to a statistically significant degree compared to the control group (4.5 +/- 3.0 minutes), the difference was of no clinical significance. Thus, continuous electromyographic and EEG monitoring with the Datex ABM device did not significantly improve administration of methohexital during brief outpatient procedures.

Adjuvants, Anesthesia↗
PubMed1993

Anaesthesia in rural Queensland: clinical experience with the Flying Obstetric and Gynaecology Service.

The Flying Obstetric and Gynaecology (FOG) service visits 27 outback towns scattered over approximately one million square kilometers of western Queensland. The role and workload of an anaesthetist attached to the FOG Service and a prospective audit of 760 consecutive anaesthetics over a ten-month period are reported. Flying anaesthetists are in an ideal position to review standards of equipment, staffing levels, anaesthetic assistance in theatre as well as participate in both medical and nursing rural training programs. This ensures that deficiencies in anaesthetic related areas are identified and appropriate action taken. The challenge to rural practitioners must be to provide a service, of at least an equivalent standard to that of their metropolitan counterparts.

Adolescent↗
PubMedDate not supplied

[Adverse effects and recovery after total intravenous anesthesia in children].

INTRODUCTION: Propofol has proven to be a reliable anaesthetic that can be used for both induction and maintenance purposes in most common surgical procedures, either in standard anaesthetic practice or as part of total intravenous anaesthesia (TIVA). MATERIAL AND METHODS: Twenty healthy (ASAI) paediatric patients scheduled for elective minor abdominal or urology surgery were studied. Patients aged 7-16 years, weighing 25-64 kg, were premedicated with midazolam 0.1mg/kg and atropine 0.01mg/kg intramuscularly, 30 minutes before surgery. Induction dose of propofol for all patients was 2.5 mg/kg. Anaesthesia was maintained with an infusion of propofol 10 to 15 mg/kg/h. Fentanyl was injected 1-2 micrograms/kg 1 minute before the start of the infusion of propofol, just before the surgery and during the surgery if necessary. Pulse, blood pressure, respiratory rate, tidal volume, ETCO2, and O2 saturation were continuously recorded before, during and after the anaesthesia. Recovery scores were assessed with the Steward scoring system 3, 5, 15, 30, after the end of anaesthetic infusion. Blood was sampled 2 and 15 minutes after the induction, 5, 15 and 30 minutes after the end of propofol infusion. RESULTS: There were no significant differences in age, weight, sort and length of the operations. After the induction spontaneous movements were registered in 35% of the patients, apnea in 25% and decrease in blood pressure in all patients. Maintenance was generally uneventful and there were no excitatory or other adverse effects. Blood concentration of propofol was followed during the anaesthesia and recovery period. Blood propofol concentration at which responses to surgery were not present were from 3.4 micrograms/ml to 4.5 micrograms/ml. Recovery was rapid and complete. All patients reached maximum value of Steward scoring system within the first 15 minutes. In the moment when patients open to command (7.2 +/- 3.2 min) average blood concentration was 1.9 micrograms/ml and when they were orientated (13.1 +/- 2.1 min) 1.3 micrograms/ml. Postoperative nausea and vomiting were not registered. DISCUSSION: This study shows that propofol provides satisfactory, stabile anaesthesia for children with rapid and complete recovery. Children may need larger doses of propofol for induction and maintenance of anaesthesia. Results from literature suggest that propofol is metabolised faster in children than in adults (9). The incidence of side effects was low. Large vein of the forearm or antecubital fossa were used for injection of propofol and there was no pain during administration the drug. Induction dose was given slowly (over 40 seconds) and apnea was relatively rare (25%). Decreases in arterial pressures from baseline levels are known to occur with propofol but in this study it was less than in others. We find a relatively high incidence of spontaneous movements during induction (35%). Nausea and vomiting were not recorded. A continuous infusion of propofol, as described here, effectively produced stable anaesthesia without use of inhalation agents. It must be remembered that propofol possesses only hypnotic properties and additional analgesia is necessary, fentanyl is a satisfactory agent in this respect. We found that average blood propofol levels of 3.5 +/- 0.9 micrograms/ml were necessary to prevent autonomic responses during this sort of surgery. Suggested hypnotic blood levels of propofol in literature are from 2.5 to 6 micrograms/ml (5). The usual endpoints of anaesthesia (eye opening and orientation) have been measured by several authors and found to occur at concentrations of the ranges of 1.0 to 2.9 micrograms/ml and 0.6 to 1.8 g/ml, respectively. CONCLUSION: Due to greater ease of control in regard to anesthetic depth and more rapid recovery, propofol is superior to other intravenous hypnotics for maintenance of anaesthesia.

Adolescent↗
PubMed1999

Comparison of clonidine 1 microgram kg-1 with morphine 30 micrograms kg-1 for post-operative caudal analgesia in children.

In a prospective randomized study in children, we compared caudal bupivacaine-clonidine with bupivacaine-morphine to evaluate whether clonidine can be used as an alternative to morphine in caudal anaesthesia. Caudal anaesthesia was administered in 36 children undergoing orchidopexy, hernia repair or circumcision, using 1.5 mL kg-1 bupivacaine 0.18% with either 1 microgram kg-1 clonidine (group 1) or 30 micrograms kg-1 morphine (group 2). Haemodynamic and respiratory parameters, anaesthetic requirements, recovery time and pain score were monitored for 24 h. Eleven children in group 1 and nine children in group 2 did not need any supplementary systemic analgesics throughout the 24-h observation period. Mean (+/- SD) duration of analgesia in the remaining patients was 6.3 h (+/- 3.3 h) in group 1 and 7.1 h (+/- 3.4 h) in group 2 (P = 0.43). Recovery time after anaesthesia was significantly longer in group 1 (16.6 +/- 8.8 min) than in group 2 (11.5 +/- 4.7 min) (P < 0.05). We conclude that analgesia provided by 1 microgram kg-1 clonidine added to caudal bupivacaine is comparable with that provided by 30 micrograms kg-1 caudal morphine with bupivacaine. Clonidine at this low dose did not cause respiratory depression.

Abdomen↗
PubMed1991

Time course of ventilatory depression following induction doses of propofol and thiopental.

To improve our understanding of the respiratory pharmacology of intravenous induction agents, the authors compared the acute effects of intravenous (iv) propofol 2.5 mg.kg-1 and iv thiopental 4.0 mg.kg-1 on the ventilatory response to CO2 (VeRCO2) of eight healthy volunteers. The slope of VeRCO2 decreased from 1.75 +/- 0.23 to a minimum of 0.77 +/- 0.14 1.min-1.mmHg-1 (mean +/- standard error) 90 s after propofol; similarly, the slope of VeRCO2 decreased from 1.79 +/- 0.22 to a minimum of 0.78 +/- 0.23 l.min-1.mmHg-1 30 s after thiopental. For both drugs, the slope was less than control in the 0.5-5-min period after injection (P less than 0.05). The slope returned to baseline within 6 min after thiopental; in contrast, after propofol, the slope remained less than control for the entire 20-min follow-up period (P less than 0.05 at 6-10, 11-15, and 16-20 min after injection). Also, from 6-10, 11-15, and 16-20 min after injection, the slope was less after propofol than at corresponding times after thiopental (P less than 0.05). Recovery of consciousness was approximately 4 min slower after propofol than after thiopental; nonetheless, awareness scores returned to baseline within 14 min after both drugs. The authors conclude that propofol 2.5 mg.kg-1 iv produces longer-lasting depression of VeRCO2 than a 4.0 mg.kg-1 iv dose of thiopental; after propofol, ventilatory depression may persist despite apparently complete recovery of consciousness.

Adult↗