[Propofol anesthesia for ophthalmologic surgery in the elderly]

Fifty patients more than 70 years old, ASA I and II, NYHA I and II, were anaesthetized by propofol for cataract or retinal detachment surgery. Induction was carried out by a propofol slow injection (0.5-1 mg.s-1) until loss eyelash reflex (mean dose 0.728 mg.kg-1) and completed by fentanyl 2 micrograms.kg-1 and vecuronium 0.08 mg.kg-1. After intubation, anaesthesia was maintained with nitrous oxide and continued infusion of propofol (mean dose 4.48 mg.kg-1.h-1) according to haemodynamic parameters. These were noted repeatedly and statistically analyzed. No significative differences were observed with younger patients undergoing identical surgical procedures. Haemodynamic effects were the same during cataract or retinal detachment surgery and in hypertensive treated patients vs non hypertensive ones. Recovery was as fast and good as in younger patients. It should be emphasized that propofol doses must be reduced in elderly patients so as to preserve a satisfactory haemodynamic stability. Reasons for increased sensitivity to propofol in elderly patients are briefly discussed.