Sedaçäo com Propofol durante anestesia peridural / Propofol by infusion for sedation during epidural anesthesia

RESUMO

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