The Comparison of Recovery Characteristics Following Anesthesia with Propofol, Sevoflurane or Isoflurane in Adults Undergoing Outpatient Surgery / 대한마취과학회지

BACKGROUND:Outpatient surgery has recently grown in popularity. This trend has affected the practice of anesthesia and has also led to an increasing interest in the development and use of short-acting anesthetic and analgesic agents. METHODS: One hundred fifty patients scheduled for outpatient surgery were randomly allocated to receive propofol, sevoflurane or isoflurane anesthesia with tracheal intubation. Clinical recovery times were analyzed as emergence, recovery, cognition and discharge. All adverse events were noted. RESULTS: Sevoflurane resulted in significantly shorter times to emergence (2.9 min), recovery (4 min), cognition (5.5 min) and discharge (13.4 min) than isoflurane. Propofol resulted in shorter times to emergence (2 min), recovery (2 min), cognition (3 min) and discharge (6.6 min) than isoflurane, but these were not significant. Also, sevoflurane resulted in shorter times to emergence, recovery, cognition and discharge than propofol, but not significantly. Among the adverse events noted, the percentages of postoperative nausea and vomiting (PONV) after anesthesia were 8%, 20% and 24% for the those who received propofol, sevoflurane and isoflurane, respectively. Propofol resulted in a significantly lower incidence of PONV than sevoflurane or isoflurane. There was no significant difference between sevoflurane and isoflurane in this respect. CONCLUSIONS: Sevoflurane and propofol are better anesthetics than isoflurane for outpatient anesthesia because of their rapid recovery times and a lower incidence of postoperative nausea and vomiting.

A Case of Anesthetic Management in a Patient for Clipping of Intracranial Aneurysm with Complete Left Bundle Branch Block: A Case Report / 대한마취과학회지

We experienced a case of clipping of an intracranial aneurysm of a 63 year old male with a subarachnoid hemorrhage under general anesthesia. Preoperative electrocardiography showed complete Left Bundle Block (LBBB) without subjective symptoms. Among the intraventricular blocks, bundle branch block is the most common type and in particular, complete LBBB may progress to the more serious condition of complete heart block. Consideration of anesthetic management in such patients requires a knowledge of normal cardiac physiology, neurophysiology, the circulatory effects of various anesthetic agents and the pathophysiology of these diseases, to prevent any hypertension in response to intubation and surgery. We report upon the anesthetic management of a patient for clipping of an intracranial aneurysm with complete LBBB, which was performed successfully without complication.

The Comparision of Antiemetic Effects of Propofol, Ondansetron, Droperidol and Metoclopramide in Patients Undergoing Middle Ear Surgery / 대한마취과학회지

BACKGROUND: This study was designed to compare the antiemetic effects of propofol, ondansetron, droperidol and metoclopramide for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing middle ear surgery. METHODS: One-hundred-twenty patients were scheduled for middle ear surgery (tympanomastoidectomy and tympanoplasty). Patients received propofol (0.5 mg/kg), ondansetron (60microgram/kg), droperidol (20microgram/kg) or metoclopramide (0.2 mg/kg) intravenously at the end of the surgical procedure. The assesment of PONV was performed during 3 periods after receiving anesthesia; 0 to 2 hours in the postanesthetic care unit, 2 to 12 hours and 12 to 24 hours in the ward. RESULTS: The percentage of no emesis during the 0 to 2 hour period after receiving anesthesia was 93% for the those who received propofol, 73% for the those who received ondansetron, 70% for the those who received droperidol, and 70% for the those who received metoclopramide. The respective corresponding incidence during the 2 to 12 hour period after receiving anesthesia was 86%, 66%, 63%, and 63%, and the respective corresponding incidence during the 12-24 hour period after receiving anesthesia was 90%, 66%, 66%, and 66%. No clinically adverse events were observed in any of the groups. CONCLUSIONS: A small dose of propofol is a better antiemetic than ondansetron, droperidol or metoclopramide for prevention of postoperative nausea and vomiting after middle ear surgery.