SEARCH · PubMed Health

Results for “Propofol”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

PubMed2000

[Effect of propofol and propofol combined with ketamine on cardiovascular system].

OBJECTIVE: To prevent blood pressure from reducing caused by injection of propofol. METHODS: Thirty patients, ASA Grade I-II, were randomly allocated into one of the two groups: Group I (Group P, n = 15) and Group II (Group K + P, n = 15), the patients received 2 mg.kg-1 propofol in Group I and 1 mg.kg-1 ketamine before equal dose of propofol in Group II. Systolic blood pressure(SBP), diastolic blood pressure(DBP), mean blood pressure and heart rate were measured before injection and 1 min, 3 min, 5 min and 10 min respectively after injection. RESULTS: Blood pressure in Group I was significantly lower than Group II. CONCLUSION: Ketamine can attenuate the hemodynamic responses to propofol.

Adolescent↗

PubMed1991

The effect on serum lipid concentrations of a prolonged infusion of propofol--hypertriglyceridaemia associated with propofol administration.

Serum concentrations of triglyceride, cholesterol and high density lipoprotein-cholesterol (HDL-cholesterol) were measured in an ICU patient after he had received a 10-day continuous infusion of propofol. No additional parenteral lipid was given in the 72 h prior to initial sampling, but a total of 71 of 10% intralipid had been administered over the remaining 7 days. The total cumulative dose of propofol was 66.1 g (range 0.7-6.4 mg kg-1 h-1). There was no visual appearance of lipaemia. Both the serum triglyceride and cholesterol concentrations increased (triglyceride level increased to 4 times normal whereas the cholesterol elevation was minimal). The HDL-cholesterol concentration decreased. At 72 h after discontinuing the infusion of propofol the triglyceride level remained elevated, the cholesterol concentration had returned to normal and the HDL-cholesterol concentration remained unchanged. The implications of hypertriglyceridaemia are discussed.

Adolescent↗

PubMed2004

[Continuous infusion of remifentanil and target-controlled infusion of propofol for coronary surgery in elderly patients: comparison with continuous infusion of remifentanil and propofol].

OBJECTIVES: Comparison of the length of mechanical ventilation and postoperative complications after coronary surgery in elderly patients anaesthetised with propofol associated with either alfentanil or remifentanil. STUDY DESIGN: Retrospective study with an historic control group. PATIENTS: Three hundred thirty-eight consecutive patients (75-year-old or more) undergoing isolated coronary surgery. One hundred and fifty seven patients operated between January 1998 and June 2000 received alfentanil (1 microg/kg/minute) with a manually control infusion of propofol, 181 operated between July 2000 and 2002, remifentanil 0.25 microg/kg/minute with target controlled infusion of propofol (target blood concentration: 1.5 to 2 microg/ml). METHODS: The two groups were compared for preoperative and surgical data. The length of mechanical ventilation, stay in ICU and the main postoperative complications were compared between the two groups. RESULTS: Length of mechanical ventilation was significantly reduced in the remifentanil group (6 +/- 9 h vs. 13 +/- 63 h ; p <0.0001), 70% of the patients were extubated before the 6th postoperative hours against 53% in the alfentanil group (p =0.0023). This was not associated with a reduction of stay in ICU or postoperative complications. During surgery, an increased used of vasopressor was observed in the remifentanil group (40.2% vs 2.4% ; p <0.0001) with a postoperative elevation of blood concentration of CKMb (35.7 +/- 38.2 microg/l, vs. 27.7 +/- 31.9 microg/l, p =0.02). CONCLUSION: Elderly patients undergoing coronary surgery were extubated earlier with remifentanil. However, this had no effect on duration of ICU stay but was associated with an increased used of vasopressor.

Aged↗

PubMed1987

Recovery from outpatient anaesthesia: a comparison of incremental propofol and propofol-isoflurane.

Propofol was used to induce anaesthesia in 60 patients undergoing minor outpatient gynaecological procedures. Maintenance was with 66% nitrous oxide in oxygen, plus either isoflurane or 10-mg increments of propofol. Recovery was assessed using both clinical and psychomotor criteria and the results compared with those obtained in a non-anaesthetized control group. As far as the two test groups were concerned, initial recovery was more rapid in the incremental propofol group but, by 1 h after surgery, there were no differences between all three groups.

Adolescent↗

PubMed1990

Total i.v. anaesthesia with propofol-alfentanil or propofol-fentanyl.

In combination with propofol, alfentanil was compared with fentanyl for total i.v. anaesthesia in 29 women (ASA classes I, II) admitted for elective hysterectomy. Infusion rates of propofol and fentanyl were determined from the literature and from pilot studies, while alfentanil was given according to a computer program. Dosage was: propofol, bolus 1.5 mg kg-1, infusion 9 mg kg-1 h-1 for 10 min and thereafter 6 mg kg-1 h-1; fentanyl, bolus 7.5 micrograms kg-1, infusion 15 micrograms kg-1 h-1 reduced successively to 1.8 micrograms kg-1 h-1; alfentanil, bolus 60 micrograms kg-1, infusion 240 micrograms kg-1 h-1 reduced successively to 100 micrograms min-1. Induction was smooth and maintenance easy to manage in both groups. Plasma concentrations were stable with a ratio of alfentanil to fentanyl of 100:1. Recovery times were equal and short, but recovery tests performed 3 h after operation showed that alfentanil produced a greater effect on ability to concentrate and fine co-ordination.

Adult↗

PubMed2006

Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test.

BACKGROUND: Wake-up test can be used during posterior spinal fusion (PSF) to ensure that spinal function remains intact. This study aims at assessing the characteristics of the wake-up test during propofol-alfentanil (PA) vs propofol-remifentanil (PR) infusions for PSF surgery. METHODS: Sixty patients with scoliosis and candidates for PSF surgery were randomly allocated in either alfentanil (PA) or remifentanil (PR) group. After an i.v. bolus of alfentanil 30 microg kg(-1) in the PA group or remifentanil 1 microg kg(-1) in the PR group, anaesthesia was induced with thiopental and atracurium. During maintenance, opioid infusion consisted of alfentanil 1 microg kg(-1) min(-1) or remifentanil 0.2 microg kg(-1) min(-1), in the PA group and the PR group, respectively. All patients received propofol 50 microg kg(-1) min(-1). Atracurium was given to maintain the required surgical relaxation. At the surgeon's request, all infusions were discontinued. Patients were asked to move their hands and feet. Time from anaesthetic discontinuation to spontaneous ventilation (T(1)), and from then until movement of the hands and feet (T(2)), and its quality were recorded. RESULTS: The average T(1) and T(2) were significantly shorter in the PR group [3.6 (2.5) and 4.1 (2) min] than the PA group [6.1 (4) and 7.5 (4.5) min]. Quality of wake-up test, however, did not show significant difference between the two groups studied. CONCLUSION: Wake-up test can be conducted faster with remifentanil compared with alfentanil infusion during PSF surgery.

Adolescent↗

PubMed1997

A comparison of propofol with a propofol-ketamine combination for sedation during spinal anesthesia.

Propofol (P) is increasingly used as a sedative during regional anesthesia. Providing titratable sedation and rapid recovery, it can compromise hemodynamic stability. However, in combination with ketamine (K), it provides stable hemodynamics during total intravenous anesthesia, avoiding emergence phenomena. We compared the efficacy, respiratory and hemodynamic profiles, and side effects of these two sedative regimes in patients undergoing spinal anesthesia. Forty patients, ASA physical status I and II, undergoing urologic or orthopedic procedures were randomly assigned to one of two groups (n = 20 each). Group 1 (P + K) received initial doses of 0.4 mg/kg P, 0.1 mg/kg K, followed by an intravenous infusion of 1.2 mg x kg(-1) x h(-1) and 0.3 mg x kg(-1) x h(-1), respectively. Group 2 (P) received bolus 0.5 mg/kg and infusion 1.5 mg x kg(-1) x h(-1). Subsequent infusion rates were titrated to a predetermined sedation level using a 5-point score. Heart rate, arterial pressure, respiratory rate, oxygen saturation end-tidal CO2, and oxygen requirements were recorded. Sedation scores were similar for both groups. There was no difference in total propofol requirements between Group 1 (146 +/- 94 mg) and Group 2 (137 +/- 52 mg) (mean +/- SD). Mean arterial pressure was significantly higher in the P + K group, e.g., 91 mm Hg (86-94) vs 75 mm Hg (69-83) at 30 min (mean +/- SD). Administration of vasopressors and fluids as well as recovery and emergence phenomena were similar between groups. Although the described additive effect of propofol and ketamine was not confirmed, the combination conferred hemodynamic stability during spinal anesthesia.

Adult↗

PubMed2000

Changes in the auditory evoked potentials and the bispectral index following propofol or propofol and alfentanil.

BACKGROUND: Midlatency auditory evoked potentials (MLAEP) show graded changes with increasing doses of hypnotics but little change with opioids. The effect of their combination on the MLAEP was evaluated. Also, the bispectral index (BIS) was compared with the ability of MLAEP to correlate with sedation and predict loss of consciousness. METHODS: Twenty healthy volunteers were randomly assigned to receive stepped increases in propofol concentration (10 subjects) or propofol plus alfentanil 100 ng/ml (10 subjects). At baseline and at each targeted effect site concentration the mean MLAEP, BIS, measures of sedation, and drug concentration were obtained. The relation among MLAEP, BIS, and sedation score was determined. The prediction probability (Pk) was calculated and compared for BIS and MLAEP. RESULTS: The BIS and MLAEP patterns showed significant changes (Pa and Nb decreased in amplitude and increased in latency) with increasing level of sedation (P < 0.0001). The BIS correlated better with sedation scores (0.884) than did the MLAEP (P < 0.05). Pa and Nb latencies showed the best correlation with sedation levels (0.685 and 0.658, respectively). The addition of alfentanil did not affect the relation between MLAEP and loss of consciousness (P > 0.15). The BIS (Pk = 0.952) was a better predictor of loss of consciousness than were Pa and Nb amplitude (P < 0.05) but were comparable to Pa and Nb latency (Pk = 0.869 and 0. 873, respectively). CONCLUSION: MLAEP changes, like the BIS, correlate well with increasing sedation produced by propofol, and these changes in the MLAEP are independent of the presence of an opioid. Among all the MLAEP parameters, Pa and Nb latencies are the best predictors of increasing sedation and loss of consciousness.

Adult↗

PubMed2003

Ability of the bispectral index, autoregressive modelling with exogenous input-derived auditory evoked potentials, and predicted propofol concentrations to measure patient responsiveness during anesthesia with propofol and remifentanil.

BACKGROUND: This study was conducted to compare the performance accuracy of the independent variables Bispectral Index (BIS), A-Line ARX index (AAI), and predicted propofol effect-site concentration (CePROP) to measure the dependent variables of loss of responses to different stimulation defined as loss of response to verbal command (LORverbal), eyelash reflex (LORlash), and noxious stimulus (LORnoxious) during stepwise increased levels of propofol infusion with and without remifentanil. METHODS: Forty-five patients were randomly allocated to one of three groups (0, 2, and 4 ng/ml remifentanil) to receive graded CePROP and predicted effect compartment controlled remifentanil (CeREMI). At every step, the ability to respond to verbal command using the Observer's Assessment of Alertness/Sedation Scale (OAA/S), eyelash reflex, and electrical tetanic noxious stimulus were compared against BIS, AAI, and CePROP. Prediction probability and sensitivity/specificity were calculated. RESULTS: Increasing CeREMI increased BIS and AAI values at LORverbal and LORlash and decreased CePROP. Similar findings were found for LORnoxious. The overall prediction probability to measure the hypnotic component of anesthesia remained accurate in the three groups for BIS, AAI, and CePROP. Combined information from CePROP, CeREMI, and BIS or AAI increased the overall prediction probability for predicting the OAA/S scale and LORlash. Less accuracy to LORnoxious was found in all independent variables. CONCLUSIONS: Although BIS, AAI, and CePROP were influenced by remifentanil during propofol administration, their ability to detect OAA/S and LORlash remained accurate. Improved performance is obtained when BIS and AAI are measured in conjunction with drug targeted effect-site concentrations. Remifentanil decreases the ability of these independent variables to detect LORnoxious.

Adolescent↗

PubMed2002

Is propofol safe for procedural sedation in children? A prospective evaluation of propofol versus ketamine in pediatric critical care.

OBJECTIVES: To compare propofol with ketamine sedation delivered by pediatric intensivists during painful procedures in the pediatric critical care department (PCCD). DESIGN: Prospective 15-month study. SETTING: An 18-bed multidisciplinary, university-affiliated PCCD. INTERVENTIONS: All children were randomized to the propofol or ketamine protocol according to prescheduled procedure dates. Propofol was delivered by continuous infusion after a loading bolus dose and a minidose of lidocaine (PL). Ketamine was given as a bolus injection together with midazolam and fentanyl (KMF). Repeated bolus doses of both drugs were given to achieve the desired level of anesthesia. The studied variables included procedures performed, anesthetic drug doses, procedure and recovery durations, and side effect occurrence. The patient's parents, PCCD nurse and resident physician, pediatric intensivist, and the physician performing the procedure graded the adequacy of anesthesia. MEASUREMENTS AND MAIN RESULTS: Of the 105 procedures in 98 children, PL sedation was used in 58 procedures, and KMF was used in 47. Recovery time was 23 mins for PL and 50 mins for KMF, and total PCCD monitoring was 43 mins for PL and 70 mins for KMF. Five children (10.6%) in the KMF group and in none in the PL group experienced discomfort during emergence from sedation. Transient decreases in blood pressure, partial airway obstruction, and apnea were more frequent in the PL than in the KMF sedation. All procedures were successfully completed, and no child recalled undergoing the procedure. The overall sedation adequacy score was 97% for PL and 92% for KMF (p <.05). CONCLUSIONS: Both PL and KMF anesthesia are effective in optimizing comfort in children undergoing painful procedures. PL scored better by all evaluators, recovery from PL anesthesia after procedural sedation was more rapid, total PCCD stay was shorter with PL, and emergence from PL was smoother than with KMF. Because transient respiratory depression and hypotension are associated with PL, it is considered safe only in a monitored environment (e.g., a PCCD).

Adolescent↗

PubMed1988

Propofol for inpatient dental anaesthesia. A comparison of propofol as sole anaesthetic agent with thiopentone and halothane for inpatient dental anaesthesia.

The induction, maintenance and recovery characteristics of propofol anaesthesia were compared with thiopentone induction and halothane maintenance in 51 spontaneously breathing, intubated patients who underwent dental surgery. Induction with thiopentone produced fewer side effects than propofol, notably pain on injection. Control of the depth of anaesthesia was better in patients who breathed halothane than in those who received intermittent bolus doses of propofol. Recovery characteristics of the two groups were similar.

Adult↗

PubMed1989

Propofol-induced anaesthesia. Double-blind comparison of recovery after anaesthesia induced by propofol or thiopentone.

Postoperative psychomotor and cognitive recovery were assessed after anaesthesia induced by either propofol or thiopentone, and maintained with nitrous oxide and halothane in 40 unpremedicated dental patients. Performance was shown to be impaired one hour postoperatively for the whole sample in hand-eye coordination (p less than 0.001), reaction time (p less than 0.001) and digit span (p less than 0.05). There was evidence of impairment at 3 hours postoperatively in reaction time (p less than 0.05) and ataxia (p less than 0.01). Performance also deteriorated in the dexterity and aiming tasks. Patients reported significantly less clumsiness by 24 hours in blurred vision and shivering (p less than 0.05) and by 48 hours less coughing (p less than 0.05). However, there was no significant difference between groups. No evidence showed that recovery in the propofol group was faster, so it was concluded that induction with propofol offered no advantage when anaesthesia is maintained with nitrous oxide and halothane for the periods of time reported in this study.

Adolescent↗

PubMed2004

Propofol or propofol--alfentanil anesthesia for painful procedures in the pediatric oncology ward.

BACKGROUND: For children with cancer receiving curative treatment, the pain of diagnostic and therapeutic procedures is often worse than that of the disease itself. In order to evaluate if light propofol anesthesia in the pediatric oncology ward (POW) could improve the management of procedure pain and anxiety, a questionnaire was developed. METHODS: After prolonged EMLA application, 65 propofol anesthetics were performed successfully in 28 children during lumbar puncture and/or bone marrow aspiration in the POW, with short recovery time and without major adverse events. The questionnaire was mailed to the parents of the 28 children who were included in the survey. RESULTS: The return of questionnaire compliance was 89% (25 of 28), 12 females and 13 males, mean age was 7 years (range 2-16). Among those who replied, the diagnoses were acute lymphatic leukemia in 21, lymphoma in two and tumor in the other two. In the questionnaire, all parents/patients reported advantages with anesthesia in the POW compared with the operating room. In the list of stated advantages, 88% marked 'familiar nurses and doctors', 84% 'familiar environment', 80% 'closer to own room', 68% 'the child more calm', 72% 'shorter waiting-time', 60% 'faster recovery', 44% 'shorter fasting-time' and 44% 'parents more calm', as benefits. For future procedures requiring anesthesia to reduce pain, discomfort and/or anxiety, 92% of the parents/patients preferred anesthesia in the POW. CONCLUSIONS: If anesthesia is chosen for invasive procedures, this study suggest that propofol anesthesia in the POW is preferred by parents and children.

Adolescent↗

PubMed2000

[Application of total intravenous anesthesia with propofol in laparoscopic cholecystectomy: specific properties of propofol as an antioxidant].

The authors reveal the formation of free radicals in biologic objects stressing upon the influence of Propofol (Diprivan; Zeneca; London, UK) as an intravenous agent during laparoscopic cholecystectomy (LCCE) lipid peroxidation. Some LCCE surgical details help this process resulting in free radical synthesis. The antioxidant effect of Propofol in vitro constitutes a peculiar interest. This generates idea that Propofol may be used as an anesthetic or as a sedative in patients with disturbances in free radical formation.

Anesthetics, Intravenous↗

PubMed1992

Maintenance of anaesthesia with propofol--a comparative study of a stepdown infusion of propofol and a low dose infusion supplemented by incremental doses.

Forty-four patients, ASA Grade I or II, had anaesthesia induced with propofol at 100 mg min-1 followed by a maintenance rate of 6 mg kg-1 h-1 or a stepdown regimen of 10 mg kg-1 h-1 for 10 min, 8 mg kg-1 h-1 for the next 10 min and at 6 mg kg-1 h-1 thereafter. Anaesthesia was maintained with propofol infused using an Ohmeda 9000 pump supplemented by nitrous oxide and oxygen (2:1) in a Bain circuit with spontaneous ventilation. Incremental doses of 20 mg of propofol were given to both groups as clinically indicated to maintain anaesthesia. Both methods provided satisfactory maintenance of anaesthesia but significantly more incremental doses were required in the group receiving the steady rate infusion. However, a lower cumulative dose was required up to 30 min in this group but not by 40 min. A comparable fall in systolic and diastolic blood pressure and heart rate was seen in both groups. There was no difference in the recovery times between the groups and the total dose did not correlate with time to recovery.

Adult↗

PubMed1994

Propofol as sole agent for paediatric day-case dental surgery. A randomised study comparing an intravenous propofol infusion with 100% inspired oxygen versus a nitrous oxide/oxygen/halothane maintenance technique.

After intravenous induction of anaesthesia with propofol (4 mg.kg-1) 80 unpremedicated children admitted for day-case dental extractions were randomly allocated to receive either an intravenous propofol infusion whilst breathing 100% oxygen, or inhalational nitrous oxide, oxygen and halothane for maintenance of anaesthesia. In both groups, the quality of anaesthesia was acceptable to both anaesthetist and surgeon. Recovery times and postoperative analgesia requirements did not differ significantly between the two groups. No child vomited. Propofol appears to be suitable for use as a sole agent in paediatric day case dental surgery.

Anesthesia, Dental↗

PubMed1998

[Evaluation of estimated blood concentration of propofol on wake-up using "ConGrase", a software to control the syringe pump for propofol infusion].

We developed a software to control a Graseby 3500 syringe pump for propofol infusion through the serial port of Apple Macintosh/Power-Macintosh computer. This software, "ConGrase", was developed with Metrowerks CodeWarrior Professional (CWP 1) and PowerPlant framework using C++. ConGrase communicates with the syringe pump at least every three seconds, and calculates the estimated blood concentration (EBC) of propofol based on the amount of propofol actually infused by applying either the Euler or Runge-Kutta method using the three-compartment pharmacokinetic model. The parameter sets reported by Gepts et al. are used. ConGrase was released at the 44 th Annual Meeting of the Japan Society of Anesthesiology, and is distributed freely. The mean and S.D. of the emergence EBC calculated by ConGrase were 1.22 micrograms.ml-1 and 0.16 microgram.ml-1, respectively. These values are almost the same as values already reported outside Japan. The necessary wake-up time can be calculated with this estimated concentration. With this system, anesthetists can control the EBC at the required level and avoid long delays before the patients wake up after anesthesia.

Adolescent↗

PubMed1996

Comparison of propofol and a propofol-methohexitone mixture for induction of day-case anaesthesia.

We studied 99 patients undergoing day-case urological surgery, allocated randomly to receive a sleep dose of either 1% propofol or a mixture of equal volumes of 1% propofol and 0.5% methohexitone, and thereafter a standardized anaesthetic. With the exception of minor differences in intraoperative heart rate there were no significant differences between the two groups in induction properties and complications, intraoperative variables, rate of recovery or postoperative sequelae.

Adolescent↗