84093
document
Recovery following outpatient anesthesia : use of enflurane versus propofol . STUDY OBJECTIVE To compare the intraoperative conditions and postoperative recovery of patients following the use of either propofol-nitrous oxide ( N2O ) or enflurane-N2O for maintenance of outpatient anesthesia . DESIGN Randomized , single-blind study . SETTING University hospital outpatient surgery center . PATIENTS 61 ASA physical status I and II , healthy female outpatients undergoing laparoscopic surgery . INTERVENTIONS Patients were randomly assigned to one of three anesthetic regimens . Group 1 ( control ) received thiopental sodium 4 mg/kg intravenously ( i.v . ) , followed by 0.5 % to 1.5 % enflurane and 67 % N2O in oxygen ( O2 ) . Group 2 received propofol 2 mg/kg i.v. , followed by 0.5 % to 1.5 % enflurane and 67 % N2O in O2 . Group 3 received propofol 2 mg/kg i.v. , followed by propofol 50 to 160 micrograms/kg/min i.v . and 67 % N2O in O2 . All patients received succinylcholine 1 mg/kg i.v . to facilitate tracheal intubation and atracurium 10 to 20 mg i.v . to provide adequate relaxation during the maintenance period . MEASUREMENTS AND MAIN RESULTS Recovery from anesthesia was assessed by a research nurse who was unaware of the anesthetic technique used . The mean +/- SD time to eye opening was significantly longer in the thiopental-enflurane-N2O group ( Group 1 ) than in the propofol-propofol-N2O group ( Group 3 ) ( 6.1 +/- 2.5 minutes vs. 3.5 +/- 2.8 minutes , respectively ) . In addition , the mean time to respond to verbal commands was significantly shorter in the propofol induction groups compared with the thiopental induction group . However , the use of enflurane versus propofol for maintenance of anesthesia did not significantly prolong the time from arrival in the recovery room to sitting , tolerating oral fluids , walking , or being judged " fit for discharge . " There were no differences among the three groups with respect to postoperative pain or analgesic requirements . Finally , patients who received enflurane for maintenance of anesthesia had a significantly higher frequency of nausea and vomiting than the propofol maintenance group . CONCLUSION Induction of anesthesia with propofol is associated with a more rapid emergence from anesthesia than induction with thiopental . Maintenance of anesthesia with enflurane did not prolong recovery compared with maintenance with propofol , but enflurane was associated with increased frequency of postoperative nausea and vomiting .
84094
Intervention_Physical
outpatient anesthesia
84095
Intervention_Pharmacological
enflurane
84096
Intervention_Pharmacological
propofol
84097
Intervention_Pharmacological
propofol-nitrous oxide ( N2O )
84098
Intervention_Pharmacological
enflurane-N2O
84099
Intervention_Pharmacological
thiopental sodium 4 mg/kg intravenously
84100
Intervention_Pharmacological
0.5 % to 1.5 % enflurane
84101
Intervention_Pharmacological
67 % N2O in oxygen ( O2
84102
Intervention_Pharmacological
Group 2 received propofol 2 mg/kg i.v.
84103
Intervention_Pharmacological
followed by 0.5 % to 1.5 % enflurane and 67 % N2O in O2 . Group 3 received propofol 2 mg/kg i.v.
84104
Intervention_Pharmacological
followed by propofol 50 to 160 micrograms/kg/min i.v . and 67 % N2O in O2 .
84105
Intervention_Pharmacological
succinylcholine
84106
Intervention_Pharmacological
atracurium
84107
Intervention_Pharmacological
anesthesia
84108
Intervention_Pharmacological
thiopental-enflurane-N2O group ( Group 1 )
84109
Intervention_Pharmacological
propofol-propofol-N2O group ( Group 3 )
84110
Intervention_Pharmacological
propofol
84111
Intervention_Pharmacological
thiopental
84112
Intervention_Pharmacological
enflurane
84113
Intervention_Pharmacological
propofol
84114
Intervention_Pharmacological
enflurane
84115
Intervention_Pharmacological
propofol
84116
Intervention_Pharmacological
thiopental
84117
Intervention_Pharmacological
enflurane
84118
Intervention_Pharmacological
propofol
84119
Intervention_Pharmacological
enflurane
84120
Outcome_Physical
Recovery from anesthesia
84121
Outcome_Physical
mean +/- SD time to eye opening
84122
Outcome_Physical
mean time to respond to verbal commands
84123
Outcome_Physical
time from arrival in the recovery room to sitting , tolerating oral fluids , walking , or being judged " fit for discharge . "
84124
Outcome_Pain
postoperative pain or analgesic requirements
84125
Outcome_Adverse-effects
higher frequency of nausea and vomiting
84126
Outcome_Physical
emergence from anesthesia
84127
Outcome_Physical
recovery
84128
Outcome_Adverse-effects
frequency of postoperative nausea and vomiting
84129
Participant_Condition
outpatient anesthesia
84130
Participant_Condition
outpatient anesthesia
84131
Participant_Condition
outpatient
84132
Participant_Sample-size
61
84133
Participant_Condition
ASA physical status I and II
84134
Participant_Condition
healthy
84135
Participant_Sex
female
84136
Participant_Condition
outpatients
84137
Participant_Condition
laparoscopic surgery