Randomized comparison of outcome after propofol-nitrous oxide or enflurane-nitrous oxide anaesthesia in operations of long duration

Korttila, K.; Östman, Pontus L.; Faure, E; Apfelbaum, Jeffrey L.; Ekdawi, M.; Roizen, Michael F.

doi:10.1007/bf03005416

Cited by 29 publications

(4 citation statements)

References 17 publications

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“…Propofol has been shown to be superior to inhalational anesthetics in reducing emetic symptoms after surgery 17‐20 . Our results support these findings; patients who received propofol had less nausea and vomiting than those who received isoflurane.…”

Section: Discussionsupporting

confidence: 81%

Propofol‐based anesthesia as compared with standard anesthetic techniques for middle ear surgery

Jellish

Leonetti

Murdoch

et al. 1995

Otolaryngol.--head neck surg.

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OBJECTIVE: To determine whether a totally intravenous technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery. DESIGN: Prospective randomized study. SETTING: Inpatient otolaryngology service at a university medical center. PATIENTS: Physical status 1 and 2 nonobese patients with no significant history of diabetes, chronic cholecystitis, neuropathy, or neuromuscular disorders that could produce delayed gastric emptying. One hundred two patients were admitted to the study and randomly divided into three equal groups. INTERVENTIONS: Intravenous thiopental, 5 mg/kg, was administered for induction of anesthesia followed by 60% air/O2 with isoflurane, 1% to 2% end tidal, for maintenance anesthesia (group 1), The same anesthetic with the addition of droperidol, 25 μg/kg, was given after induction (group 2). Propofol, 2 mg/kg, was administered intravenously for induction of anesthesia and followed by propofol, 50 to 250 μg/kg/min, for maintenance anesthesia. All groups received fentanyl, 3 μg/kg intravenously, after induction. MEASUREMENTS AND MAIN RESULTS: Surgical duration, induction, maintenance, and total anesthesia times were recorded together with eye opening and extubation. Intergroup comparisons of postoperative nausea, vomiting, and pain, and recovery scores, we made by use of the Steward system. Patients receiving propofol, compared with the isoflurane-only group, had significantly less nausea (4/34 vs 12/34 patients, respectively; p < 0.05) and as vomiting (2/34 vs 8/34 patients, respectively; p < 0.05). Immediate recovery scores were significantly better for propofol compared with the isoflurane-droperidol group. Recovery scores at 30 minutes were also faster with propofol compared with isoflurane or isoflurane-droperidol (5.7 ± 0.1 vs 5.1 ± 0.2 and 5.2 ± 0.2; p < 0.05).

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Section: Discussionsupporting

confidence: 81%

Propofol‐based anesthesia as compared with standard anesthetic techniques for middle ear surgery

Jellish

Leonetti

Murdoch

et al. 1995

Otolaryngol.--head neck surg.

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“…Propofol also exerts anesthesia through stimulation of the GABA A R [ 16 ]. Furthermore, it has also been shown to stimulate appetite and feelings of hunger in the post-operative recovery period in humans [ 7 , 8 , 11 , 23 ]. Our results are in agreement with this observation because propofol administration markedly favored appetite in mice.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic drugs modulate feeding behavior and hypothalamic expression of the POMC polypeptide precursor and the NPY neuropeptide

et al. 2018

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BackgroundSeveral hypnotic drugs have been previously identified as modulators of food intake, but exact mechanisms remain unknown. Feeding behavior implicates several neuronal populations in the hypothalamic arcuate nucleus including orexigenic neuropeptide Y and anorexigenic pro-opiomelanocortin producing neurons. The aim of this study was to investigate in mice the impact of different hypnotic drugs on food consumption and neuropeptide Y or pro-opiomelanocortine mRNA expression level in the hypothalamic arcuate nucleus.MethodsSaline control, isoflurane, thiopental, midazolam or propofol were administered to C57Bl/6 mice. Feeding behavior was evaluated during 6 h. In situ hybridization of neuropeptide Y and pro-opiomelanocortine mRNAs in the hypothalamus brain region was also performed. Data were analyzed by Kruskal Wallis test and analysis of variance (p < 0.05).ResultsMidazolam, thiopental and propofol induced feeding behavior. Midazolam and thiopental increased neuropeptide Y mRNA level (respectively by 106 and 125%, p < 0.001) compared with control. Propofol and midazolam decreased pro-opiomelanocortine mRNA level by 31% (p < 0,01) compared with control. Isoflurane increased pro-opiomelanocortine mRNA level by 40% compared with control.ConclusionIn our murine model, most hypnotics induced food consumption. The hypnotic-induced regulation of neuropeptide Y and pro-opiomelanocortine hypothalamic peptides is associated with this finding. Our data suggest that administration of some hypnotic drugs may affect hypothalamic peptide precursor and neuropeptide expression and concomittantly modulate food intake. Thus, this questions the choice of anesthetics for better care management of patients undergoing major surgery or at risk of undernutrition.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0557-x) contains supplementary material, which is available to authorized users.

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“…Total intravenous anaesthesia with propofol, especially for middle ear operations lasting 2-5 h, does not offer any peroperative advantages as compared with volatile anaesthetics (6)(7)(8). It is also a relatively expensive anaesthetic method as compared with the use of volatile anaesthetics (3).…”

Section: ~mentioning

confidence: 99%

Comparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery

Honkavaara

Saarnivaara

1998

Acta Anaesthesiol Scand

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Randomized comparison of outcome after propofol-nitrous oxide or enflurane-nitrous oxide anaesthesia in operations of long duration

Abstract: Randomized comparison of outcome after propofol-nitrous oxide or enflurane-nitrous oxide anaesthesia in operations of long duration A randomized, prospective, comparative

Cited by 29 publications

References 17 publications

Propofol‐based anesthesia as compared with standard anesthetic techniques for middle ear surgery

Propofol‐based anesthesia as compared with standard anesthetic techniques for middle ear surgery

Anesthetic drugs modulate feeding behavior and hypothalamic expression of the POMC polypeptide precursor and the NPY neuropeptide

Comparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery

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