84468
document
[ No better vigilance after general anesthesia with propofol in colonic surgery . A comparison of three procedures for general anesthesia ( propofol , halothane and midazolam/fentanyl ) in combination with catheter epidural anesthesia ] . Early mental and psychomotor recovery was studied in 67 patients undergoing colorectal surgery under continuous epidural anaesthesia and light general anaesthesia using propofol , halothane , and midazolam/fentanyl . The study was approved by the local ethics committee . All patients received epidural anaesthesia with 0.25 % bupivacaine and were then randomly allocated to one of three groups . In group I ( halothane ) , light general anaesthesia was induced with thiopental 3-5 mg/kg and maintained with halothane . The propofol group ( II ) received 2 mg/kg for induction and a mean continuous infusion of 1.7 mg/kg.h . In group III ( Mi/Fe ) , midazolam and fentanyl were used for induction and maintenance . All patients were intubated , received non-depolarising muscle relaxants , and were manually ventilated with nitrous oxide-oxygen ( 2:1.2 ) . For postoperative analgesia , 0.05 mg/kg morphine was administrated epidurally 30 min before the end of the operation ; 30 , 60 , 90 , and 120 min after arriving in the recovery room , vigilance was assessed using a modified Steward score , the Trieger test , the ability to recall a column of numbers ( KAI test ) , and symbol counting ( CI test ) . Heart rate , blood pressure , arterial oxygen saturation , and blood gases were recorded . RESULTS . The three groups were comparable with regard to age , sex , ASA classification , and duration of anaesthesia and operation ( Table 3 ) . There was no difference between the groups in performance of the recovery tests ( Figs . 2-5 ) , blood pressure , heart rate , arterial blood gas analysis ( Fig . 6 ) , or oxygen saturation . Comparing pre- and postoperative values , we found severe psychomotor and mental impairment in all groups . pCO2 was slightly elevated in all groups , but only 3 patients in the propofol group and 6 in the midazolam/fentanyl group developed hypercapnia above 50 mm Hg . Patients receiving propofol or midazolam/fentanyl had significantly less postoperative nausea and vomiting than those receiving halothane ( Table 5 ) . CONCLUSION . It is concluded that propofol offers no advantage over halothane or midazolam/fentanyl where early postoperative recovery is concerned . Intraoperatively , all three techniques provided good anaesthesia . Propofol and midazolam/fentanyl caused less postoperative nausea and vomiting than halothane anaesthesia .
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Intervention_Pharmacological
propofol in
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Intervention_Pharmacological
general anesthesia
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
halothane
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Surgical
continuous epidural anaesthesia
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Intervention_Pharmacological
and light general anaesthesia
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
halothane
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Surgical
epidural anaesthesia
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Intervention_Pharmacological
bupivacaine
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Intervention_Pharmacological
( halothane ) , light general anaesthesia
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Intervention_Pharmacological
thiopental 3-5 mg/kg and maintained with halothane
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
midazolam and fentanyl
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Intervention_Physical
intubated
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Intervention_Pharmacological
non-depolarising muscle relaxants
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Intervention_Pharmacological
manually ventilated with nitrous oxide-oxygen
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Intervention_Pharmacological
morphine
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Intervention_Physical
epidurally
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Pharmacological
halothane
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
halothane
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Pharmacological
Propofol
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Intervention_Pharmacological
midazolam/fentanyl
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Intervention_Pharmacological
halothane
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Outcome_Other
vigilance
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Outcome_Mental
Early mental
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Outcome_Mental
psychomotor recovery
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Outcome_Physical
Heart rate , blood pressure , arterial oxygen saturation , and blood gases
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Outcome_Mental
recovery tests
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Outcome_Physical
blood pressure , heart rate , arterial blood gas analysis ( Fig . 6 ) , or oxygen saturation .
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Outcome_Mental
psychomotor and mental impairment
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Outcome_Physical
pCO2
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Outcome_Physical
hypercapnia
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Outcome_Adverse-effects
postoperative nausea and vomiting
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Outcome_Mental
postoperative recovery
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Outcome_Adverse-effects
postoperative nausea and vomiting
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Participant_Sample-size
67
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Participant_Condition
colorectal surgery
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Participant_Condition
continuous epidural anaesthesia
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Participant_Condition
light general anaesthesia