[Recovery from total intravenous anesthesia with propofol and buprenorphine]

A retrospective study was performed to evaluate recovery from total intravenous anesthesia (TIVA) with propofol and buprenorphine for various types of surgery. The patients of the study were divided into two groups; Group A: n = 85, age 66 +/- 12 Y, duration 282 +/- 102 min, with epidural block and Group B: n = 56, 52 +/- 20 Y, 172 +/- 90 min, without the block. All patients were premedicated with intramuscular midazolam (1-5 mg). Anesthesia was maintained with propofol infusion with 40% oxygen in air, and an intravenous bolus dose of buprenorphine (0.11 +/- 0.03 mg). Muscle relaxation was obtained by intravenous vecuronium. The patients of Group A were supplemented with continuous epidural anesthesia using 2% mepivacaine. The maintenance dose of propofol (Group A: 4.5 +/- 1.2 mg.kg-1.h-1, Group B: 7.0 +/- 1.8 mg.kg-1.h-1) and temperature at the end of surgery decreased significantly with age. Awakening time in all patients was 12.3 +/- 7.4 min and it was correlated significantly with age and hypothermia, but not correlated with the maintenance dose or duration of propofol infusion. In short-duration surgery (within 2 hours, n = 36) awakening time was correlated with neither age nor temperature. There was no difference in awakening time between genders. Requirement for analgesics within 20 hours was 18.8% in Group A and 14.3% in Group B. Four patients (2.8%) reported dreaming, but none of the patients recalled the intraoperative events. We suggest that in elderly patients the reduction of intravenous anesthetics, maintenance of normothermia and short-duration surgery would result in rapid recovery in TIVA.