[The use of propofol in carotid surgery]

To compare two anesthetic techniques in carotid surgery. The first technique was propofol in continuous perfusion throughout the procedure (group A) and the other used etomidate for anesthetic induction and isoflurane for maintenance (group B).

The patients were assigned randomly either to group A (n = 23) to receive propofol in continuous perfusion for induction (0.8-1 mg/kg) and for maintenance (4-6 mg/kg/h) or to group B (n = 25) to receive etomidate (0.25 mg/kg) for induction and isoflurane 0.6-0.8% for maintenance. Ventilation was maintained with O2/N2O. Systolic and diastolic arterial pressures (SAP and DAP) and heart rate were measured at baseline, during induction (minutes 1, 2, 3, 5 and 10), immediately before and 1 minute after interruption of carotid flow, once flow had been released and after extubation. Other variables recorded were time until awakening and extubation, presence of pain, degree of well-being, need for analgesics and vasodilators, perioperative complications and time until hospital release.

The variations in hemodynamic parameters during induction and during maintenance were similar for both techniques. Orotracheal intubation increased SAP in both groups. Time until eye opening and awakening were shorter in group A but the difference was not statistically significant.

The use of propofol for induction and maintenance during carotid surgery was as safe as conventional anesthetic technique with etomidate and isoflurane.