Disoprofol and fentanyl for total intravenous anaesthesia

Abstract

Summary Ninety patients undergoing a variety of surgical procedures were anaesthetised with a disoprofol infusion Key wordsAnaesthetics, intravenous; disoprofol. Analgesic, narcotic; fentanyl.Intravenous anaesthesia without inhalational supplements is theoretically attractive particularly at a time when argument continues over the possible harmful effects of waste anaesthetic gases. The fact that intravenous anaesthesia appears to be used by only a few enthusiasts reflects both the difficulty of some techniques and the absence of a completely suitable agent. There are few methods of total intravenous anaesthesia which combine good operating conditions and rapid recovery without the aid of muscle relaxation, and few if any intravenous hypnotic agents are useful without the addition of analgesics.A new intravenous induction agent, disoprofol (2-6 di-isopropyl phenol) has some of the properties required of an agent to maintain anaesthesia. Induction of anaesthesia has been reported to be smooth and recovery rapid, even when multiple doses had been administered.' This paper reports on the authors' experience of 90 administrations of disoprofol for total intravenous anaesthesia and in particular on the attempt to find a suitable dose regimen. MethodNinety patients aged between 18-75 years and ASA category 1 or 2 gave informed consent to the investigation. Patients with a history of atopy or allergy were excluded, as were patients weighing more than 100 kg and those who had received Cremophor within the previous 12

Optimal Dose of Lignocaine for Preventing Pain on Injection of Propofol

“…There were no significant differences between the four groups in age, weight, sex, ASA physical (14) 82 (15) 70 (15) 66 (12) 82 (12) 62 (11) Group B (n = 86) 91 (13) 78 (13) 69 (11) 66 (10) 84 (13) 68 (11) Group C (« = 71) 95 (10) 81 (14) 71 (10) 64 (11) 80 (16) 65 (12) Group D (n = 76) 91 (15) 80 (11) 68 (9) 67 (8) 85 (11) 63 (10) status, premedication and duration of anaesthesia (table I). Haemodynamic changes were similar in the four groups (table II) and no patient developed cardiac events associated with lignocaine.…”

“…Several attempts have been made to reduce the incidence of pain, such as prior administration of opioids [15] or aspirin [16], the use of a largegauge cannula [10], injection into a large vein rather than one on the dorsum of the hand [5], 50% dilution in a glucose solution [14], and the use of EMLA cream applied to the skin 1 h before cannulation [6]. The data from all these studies are difficult to compare because of variation in study design.…”

Intravenous anaesthesia: manual infusion schemes versus TCI systems

“…In a further study, Major et al . induced and maintained anaesthesia with infusions of propofol in 90 (ASA I or II) healthy patients, who were premedicated with pethidine and promethazine [3]. Patients underwent a variety of surgical procedures (some requiring muscle relaxation), breathed oxygen enriched air and received supplementary boluses of fentanyl.…”

Hepatic and Extrahepatic Disposition of Propofol in Patients Undergoing Coronary Bypass Surgery

“…Complications with the solvent Cremophor EL led to the formulation of a soy-bean oil emulsion [2]. Clinical studies with both preparations suggested that propofol should serve as a short acting hypnotic drug, ideally suited for day-case anaesthesia [3,4] or other routine operations [5]. Comparison of the two formulations in the literature suggest that, for induction of anaesthesia, the dose requirement of the emulsion form seemed to be higher than that of the Cremophor EL preparation [6,7].…”