ABSTRACT
Background and Objectives - Propofol is a good agent for intravenous infusaion because of its pharmacokinetic properties, such a high clearance and short elimination half-line. The aims of this non-comparative study were: to determine the total dose and the infusion rate of propofol for moderate sedation during epidural anesthesia; to examine cardiovascular and respiratory responses; and to evaluate postanesthetic recovery. Methods - Thirty adult physical status ASA I - II patients, aged 38.08 +- 12.58 years, undergoing elective surgeries under epidural anesthesia were studied. After an initial dose of 2.0-2.5 mg.Kg-1, a continuous intravenous infusion of propofol was maintained and the infusion rate was adjusted to provide moderate sedation. Propofol was discontinued at the end of the surgery. Results - The mean duration of the procedure was 88.16 +- 41.19 min. The mean total dose of propofol was 6.75 +- 2.13 Mg.Kg-1 and the mean infusion rate 3.19 +- 1.17 mg.Kg-1.h-1. The mean time for regression to stage IV (orientated in time and space) was 4.23 +- 0.76 min. Despite a reduction in arterial pressure after installation of the epidural block, there was no further reduction during the propofol infusion. A vasopressor was needed in 20 percent of patients. Cardiac rate remained stable both after installation of the epidural block and during the infusion. Conclusions - propofol intravenous infusion produces good and easily controllable sedation as an adjunct to epidural anesthesia, with few hemodynamic changes other than those inherent to epidural block, and immediate retur of consciousness and restoration of higher mental function at the end of the procedure
Subject(s)
Humans , Male , Female , Adult , Analgesia, Epidural , Propofol/administration & dosage , Propofol/adverse effects , Conscious Sedation/methodsABSTRACT
Os autores compararam a efetividade do midazolam sublingual com o midazolam intravenoso como pré-medicaçao em EDA, envolvendo 80 pacientes divididos em dois grupos. O grau de sedaçao, cooperaçao durante o procedimento e o grau de amnésia após o exame foram comparados, bem como os efeitos na PA, FC e FR, que foram similares para as duas vias de administraçao, com exceçao da amnésia anterógrada, que foi mais efetiva no grupo intravenoso. Concluem que o uso de midazolam sublingual tem efetividade semelhante ao intravenoso, porém com custo menos elevado, determinando maior praticidade na execuçao do procedimento.