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The influence of nitrous oxide on propofol dosage and recovery after total intravenous anaesthesia for day‐case surgery
Author(s) -
LINDEKÆR A. L.,
SKIELBOE M.,
GULDAGER H.,
JENSEN E. W.
Publication year - 1995
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1995.tb05991.x
Subject(s) - medicine , nitrous oxide , propofol , anesthesia , target controlled infusion , remifentanil
Summary We studied the influence of nitrous oxide on the maintenence dose of propofol and recovery characteristics in 42 patients, aged 18–62 years, ASA 1 or 2, scheduled for day case inguinal herniotomy. Using a double‐blind, randomised design, patients received anaesthesia with propofol‐alfentanil‐vecuronium‐oxygen and either nitrous oxide or room air (Fio 2 = 0.30). The rate of propofol infusion was adjusted depending on anaesthetic depth as judged using standard clinical criteria; alfentanil was administered on a weight basis. Patients’ lungs were manually ventilated after tracheal intubation and muscle relaxation was reversed at the end of surgery with neostigmine and atropine. A series of psychomotor tests was performed pre‐operatively and 30 and 120min postoperatively. The mean maintenance doses of propofol were 0.084 mg .kg ‐1 .min ‐1 in the N 2 O group and 0.088 mg.kg ‐1 .min ‐1 in the air group (p = 0.97). In the nitrous oxide group the mean (SD) interval to spontaneous eye opening was 13.1 (7.3) min compared to 8.1 (4.9)min in the air group (p = 0.01). Similarly, the interval until obtaining a standardised response was 13.5 (5.3) min and 9.8min (5.4) in the nitrous oxide and air groups, respectively (p = 0.04). The addition of nitrous oxide to propofol‐alfentanil‐vecuronium anaesthesia does not reduce propofol requirements and prolongs early recovery compared to air.