TOTAL I.V. ANAESTHESIA WITH PROPOFOL AND ALFENTANIL: DOSE REQUIREMENTS FOR PROPOFOL AND THE EFFECT OF PREMEDICATION WITH CLONIDINE |
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Authors: | RICHARDS, M. J. SKUES, M. A. JARVIS, A. P. PRYS-ROBERTS, C. |
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Affiliation: | Sir Humphry Davy Department of Anaesthesia, University of Bristol Bristol Royal Infirmary, Bristol BS2 8HW |
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Abstract: | We determined in 51 healthy patients undergoing body surfacesurgery the dose requirements for propofol, as part of a totali.v. anaesthesia technique with an alfentanil infusion. Afterpremedication with temazepam, patients received alfentanil 50µg kg1 followed by an infusion of 50 µg kg1h1. Patients were anaesthetized with a loading dose ofpropofol followed by a three-stage infusion designed to reachone of five preselected blood concentrations of propofol. Themotor response to the initial surgical incision was noted andprobit analysis was used to derive the ED50 (2.94 mg kg1h1; 95% confidence limits: 2.353.37 mg kg1h1). and ED95 (4.98 mg kg1 h1; 95% limits:4.138.8 mg kg1 h1) for the final propololinfusion rate under these conditions. Whole blood concentrationof propofol at the time of the incision was related linearlyto the infusion rate and the EC50 and EC95 (probit analysis)were derived as 1.44 (95% confidence limits 0.621.87)and 4.05 (95% confidence limits 2.7830.5) µg ml1,respectively. Postoperative recovery was rapid, uncomplicatedand uneventful. In a subgroup of eight patients, the additionof clonidine 0.6mg to the premedication significantly decreasedthe requirement for propofol (P <0.05) during surgery, butresulted in prolonged recovery times. Pilot study presented to the Anaesthetic Research Society, June24, 1988 [1]. |
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