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Continuous sedation during spinal anaesthesia: gamma-hydroxybutyrate vs. propofol
S Kleinschmidt1, C Schellhase, F Mertzlufft
1Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg-Saar, Germany.
European Journal of Anaesthesiology
|March 20, 1999
Summary
Gamma-hydroxybutyrate (GHB) offers stable hemodynamics and minimal respiratory depression, making it a viable alternative to propofol (PRO) for sedation during spinal anesthesia. Recovery times with GHB are slightly longer but clinically acceptable.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Gamma-hydroxybutyrate (GHB) exhibits sedative properties and cardiovascular stability, similar to propofol (PRO).
- Sedative dosages of GHB ensure adequate clinical recovery, unlike its use as a narcotic agent.
Purpose of the Study:
- To compare the clinical efficacy and safety of GHB versus PRO for continuous sedation during spinal anesthesia (SPA).
Main Methods:
- A randomized study involving 30 patients (ASA I and II) receiving either GHB or PRO for sedation during SPA.
- A control group (n=15) received saline.
- Simultaneous assessment of hemodynamic, respiratory, endocrinological parameters, and clinical side-effects at eight time points.
Main Results:
- Both GHB and PRO achieved the desired sedation levels.
- Recovery times were 1.7 ± 0.9 min for PRO and 6.1 ± 4.9 min for GHB.
- GHB maintained stable hemodynamics without significant respiratory depression, unlike PRO which decreased MAP by 15% and RMV by 53%.
Conclusions:
- GHB is a suitable alternative for continuous sedation during SPA, offering stable hemodynamics and acceptable recovery.
- GHB presents a potentially safer option regarding respiratory depression compared to PRO.