The propofol requirements for the induction and maintenance of anaesthesia were compared in groups of younger and older patients. Side effects, influence on the cardiovascular system and recovery times were compared between 20 unpremedicated ASA I-III, 25-40-yr-old patients and 20 65-80-yr-old patients all scheduled to undergo elective surgery. After induction with propofol, anaesthesia was maintained with a continuous infusion of the drug. Vecuronium and fentanyl were administered as required. In the young group propofol 2.2 mg kg-1 and in the elderly 1.7 mg kg-1 were needed for induction (P less than 0.05). The maintenance doses were 10.0 mg kg-1 h-1 and 8.6 mg kg-1 h-1, respectively (P less than 0.01). Side effects were more pronounced in the younger patients. Influences on the cardiovascular system were definite, but mild. The younger patients awoke sooner: 7.8 v. 14.3 min (P less than 0.01) after the discontinuation of the infusion of propofol.
To provide general anaes hesia with endotracheal intubation during regional blockades, three dose regimens of propofol emulsion were studied: induction 2 mg kg‐1, infusion rate 9 mg kg‐1 h‐ (Group I); induction 2.5 mg kg‐1, infusion rate I? mg kg‐1 h‐1 (Group 2); induction 2.5 mg kg‐1, infusion rate 9 mg kg‐1 (Group 3). Each group comprised 10 healthy (ASA class 1 or 2) unpremedicated patients. The induction times measured from the start of injection until counting ceased (± 50 s) and until eye‐lash reflex disappeared (± 80 s) showed no statistical differences between groups. In five patients in Group 1 and one patient in each of Groups 2 and 3 the induction dose was too low for intubation. Pain on injection was seen in 13 cases (mild 6, moderate 6 and severe I). Cough accompanied by hypersalivation was the most important side‐effect. Recovery times varied widely and showed no statistical differences. Answering simple questions was possible after 14 min in Group 1, 23 min in Group 2 and 19 min in Group 3. Apart from a short period of euphoria, recovery was uneventful. There was no tendency to fall asleep again. None of the combinations of induction doses and infusion rates provided good anaesthesia conditions for an acceptable number of patients.
There is lack of agreement between femoral venous oxygen saturation and central venous oxygen saturation in both stable and unstable medical conditions. Thus, femoral venous oxygen saturation should not be used as surrogate for central venous oxygen saturation.
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