The subjective effects of low‐dose propofol A double‐blind study to evaluate dimensions of sedation and consciousness with low‐dose propofol

Whitehead, Caroline; Sanders, Lalage; Oldroyd, G. J.; Haynes, T. K.; Marshall, R. W.; Rosen, Michael J.; Robinson, J. O.

doi:10.1111/j.1365-2044.1994.tb03518.x

Cited by 30 publications

(5 citation statements)

References 33 publications

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“…2 Although documented anecdotally, propofol-induced improvement of mood and well-being could not be reproduced in a randomized experimental human study. 12 The evidence is that propofol has only a minimal effect on vomiting in paediatric strabismus surgery, a clinical situation with a particularly high risk of PONV. 13 The aim of this meta-analysis was therefore to test the evidence that propofol, when used for induction or maintenance of anaesthesia, decreases the incidence of PONV compared with other anaesthetic techniques.…”

mentioning

confidence: 99%

Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.

Tramèr¹,

Moore²,

McQuay³

1997

British Journal of Anaesthesia

273

112

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We have analysed randomized controlled studies which reported the incidence of postoperative nausea and vomiting (PONV) after propofol anaesthesia compared with other anaesthetics (control). Cumulative data of early (0-6 h) and late (0-48 h) PONV were recorded as occurrence or non-occurrence of nausea or vomiting. Combined odds ratio and number-needed-to-treat were calculated for propofol as an induction or maintenance regimen, early or late outcomes, and different emetic events. This was performed for all control event rates and within a range of 20-60% control event rates. We analysed 84 studies involving 6069 patients. The effect of propofol on PONV was dependent mainly on the method of administration, time of measurement and range of control event rates. When all studies were included the number-needed-to-treat to prevent PONV with propofol was more than 9 when used for induction of anaesthesia and at best 6 when used for maintenance. Within the 20-60% control event rate range, best results were achieved with propofol maintenance to prevent early PONV: the number-needed-to-treat to prevent early nausea was 4.7 (95% confidence interval 3.8-6.3), vomiting 4.9 (4-6.1) and any emetic event 4.9 (3.7-7.1). Within the 20-60% control event rate, of five patients treated with propofol for maintenance of anaesthesia, one will not vomit or be nauseated in the immediate postoperative period who would otherwise have vomited or been nauseated. This may be clinically relevant. In all other situations the difference between propofol and control may have reached statistical significance but was of doubtful clinical relevance. Treatment efficacy should be established within a defined range of control event rates for meaningful estimates of efficacy and for comparisons.

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mentioning

confidence: 99%

Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.

Tramèr¹,

Moore²,

McQuay³

1997

British Journal of Anaesthesia

273

112

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“…18,19 Several studies investigated the effects of modern, short-acting anesthetic. 12,15,20 Thapar et al 15 found significant initial impairment of psychomotor function with various combinations of commonly used sedative drugs (propofol, midazolam, fentanyl). Combinations that included midazolam had the most long-lasting effects, but after 3 h none of the regimens showed any relevant effect.…”

Section: Driving After Ambulatory Surgerymentioning

confidence: 98%

Car Accidents After Ambulatory Surgery in Patients Without an Escort

Chung

Assmann

2008

Anesthesia &Amp; Analgesia

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Occasionally, ambulatory surgical patients present without an escort for their procedure. This creates a dilemma for caregivers, and allowing patients to drive may have an impact on their safety. The Canadian Medical Protective Association is a mutual defense organization for 95% of Canadian physicians. The national database is a unique and extensive repository of medico-legal data. We scanned this database for malpractice patients who were discharged after an ambulatory surgery procedure and allowed to drive home with a poor outcome. From this database, two malpractice cases of patients who were discharged without an escort after an ambulatory surgical procedure were reported. Both had a car accident and sustained serious injuries. Based on this we do not recommend discharge without an escort after general anesthesia, regional anesthesia, monitored anesthesia or sedation. Driving after ambulatory surgery cannot be considered safe and caregivers need to verify a safe ride home.

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“…10 In healthy volunteers or patients requiring sedation, continuous infusion of propofol increases sedation in a dose-dependent manner. 11,12 Combinations of propofol with midazolam 13,14 produce synergistic hypnotic effects, while combinations of propofol with fentanyl had additive hypnotic effects. 13, 15 Hypnotic doses of propofol may have analgesic qualities, 13,16,17 although propofol is not considered an analgesic agent.…”

Section: Pharmacodynamicsmentioning

confidence: 99%

Propofol Infusion and the Potential Use of Propofol Patient-Controlled Sedation (PCS) in Terminally 111 Patients

Smith

El-Mohtar

2006

WJCP

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Sedation in end-of-life care is an accepted, but nonetheless controversial, means of providing relief from otherwise refractory and intolerable symptoms and distress. For purposes of this article, the terms 'palliative sedation' and 'patient-controlled palliative sedation' (PCS) will be used to describe clinician-controlled or patient-controlled drug delivery. Ideally, therapy should improve symptoms without unfavorably affecting the patient's level of perception or capacity to communicate with friends and family members. Benzodiazepines, opioids, and certain neuroleptics have been used for palliative sedation with variable success and satisfaction rates. Propofol is a sedative-anesthetic with unique pharmacological properties which may prove highly desirable for use in selected terminally ill patients. There are few case reports and studies about using propofol as a continuous infusion for palliative sedation. Propofol-PCS has been used for sedation in certain surgical procedures in both young and elderly patients; however, its use in terminally ill patients has not been described. The authors postulate that propofol PCS may offer potential benefits for use in various situations at certain stages during terminal sedation.

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The subjective effects of low‐dose propofol A double‐blind study to evaluate dimensions of sedation and consciousness with low‐dose propofol

Cited by 30 publications

References 33 publications

Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.

Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.

Car Accidents After Ambulatory Surgery in Patients Without an Escort

Propofol Infusion and the Potential Use of Propofol Patient-Controlled Sedation (PCS) in Terminally 111 Patients

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