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To the Editor: Propofol is useful not only as the sole agent for induction and maintenance of anaesthesia, but also as an adjunct during emergence after the use of a volatile anaesthetic. With the advent of procedures such as laparoscopy, it is often difficult to predict accurately when the procedure will end. Delivery of a volatile agent up to the end of the surgical procedure may delay emergence. In order to allow removal of the agent, its concentration is frequently reduced or eliminated in anticipation of completion of the case. Our timing is often misguided and the patient may require additional anaesthesia briefly during the final moments of surgery. Possible options include the use of: (1) an intravenous agent such as a barbiturate or propofol, (2) a narcotic, (3) a muscle relaxant, or (4) the volatile anaesthetic gas. I have found that the use of a subanaesthetic dose of propofol, i.e., 10--30 mg is sufficient to provide excellent anaesthesia at the final moments of surgery without delaying emergence. Due to its rapid distribution 13 and metabolism, the use of propofol is a more logical choice than (1) a barbiturate which may delay emergence and produce a less rapidly oriented patient, (2) a narcotic which may produce prolonged respiratory depression, nausea and/or vomiting, (3) a muscle relaxant which if given in close proximity to the end of the procedure may make reversal difficult, or (4) the addition of a volatile agent which may reanaesthetize the patient.

Gas mask during pregnancy and labour