Comparison between propofol and midazolam/flumazenil as intravenous anaesthetic agents for minor outpatient surgery

ABSTRACT

Forty adult patients scheduled for minor urological surgical procedures were randomly allocated to two equal groups for anaesthesia. One group was administered propofol, a new class of intravenous anaesthetic agents chemically unrelated to the barbiturates, steroid or eugenol agents, the other group was given midazolam, a new short-acting benzo-diazepine. In both groups this was followed by fentanyl and nitrous oxide, but in the midazolam group flumazenil, a specific benzodiazepine antagonist, was administered at the end of surgery. Both techniques provided good-quality anaesthesia, and there was no difference in recovery times as judged by the patients' ability to open their eyes and give their date of birth. However, those who received propofol were able to sit up unaided significantly earlier and also to carry out the Postbox and Letter Deletion Tests significantly faster. After flumazenil reversal there was no significant difference in the sedation score for 30 min, but this was followed by a significant degree of resedation. The incidence of nausea, vomiting and headache were the same in both groups. This study showed propofol to be superior to midizolam followed by flumazenil reversal as the intravenous component of outpatient anaesthesia for minor urological surgical procedures