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[Cardiocirculatory stability and early extubation in patients undergoing thoracic surgery with propofol as the single
M Tommasi Rosso1, R Garcia Aguado, M Vivò
1Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario, Valencia, Spagna.
Objective:
To determine the efficiency of total intravenous anesthesia technique (TIVA) using propofol on maintaining cardio-circulatory stability and rapid recovery time in patients undergoing thoracotomy.
Design:
Prospective study.
Setting:
University General Hospital in Spain.
Patients:
Twelve patients, undergoing elective thoracic surgery, including lung resection with one-lung ventilation with more than 120 minutes of anesthetic time.
Methods:
ECG, blood pressure (BP), heart rate (HR), pulse oximetry (SpO2), end tidal CO2 (ETCO2) and muscular relaxation with Relaxograph were monitored. Anesthesia was performed with propofol 1.5-2.5 mg/kg i.v. and maintained with continuous propofol infusion 4 +/- 1.4 mg/kg/h. Fentanyl, 10 mg i.v., was administered in bolus. After succinylcholine 1 mg/kg i.v. or atracurium 0.5 mg/kg i.v., trachea was intubated with a double-lumen tube or a standard cuffed endotracheal tube. The patients were ventilated with air-oxygen mixture. Maintenance of muscular relaxation was obtained with atracurium 0.2 mg/kg i.v.
Results:
No significative differences were registered in the values of heart rate, SpO2, ETCO2 and between intraoperative blood pressure and the postextubation blood pressure values. Recovery time, from discontinuation of the propofol until postoperative extubation, was 8.25 +/- 4.8 minutes.
Conclusions:
Performing a TIVA with propofol good cardiocirculatory stability was obtained. Continuous monitoring of relaxation, graphically recorded, knowing the bolus rate of muscle relaxant, allows us to antagonize it totally, facilitating patient recovery and its early postoperative extubation.