[Propofol and etomidate: a comparative study in emergency anesthesia in ASA I and II patients]. / Propofol et étomidate: étude comparative en anesthésie d'urgence chez des patients ASA I et II.

The use of propofol and etomidate in emergency anaesthesia is studied in 39 patients ASA I and 11 patients ASA II. After premedication, the narcosis is induced and maintained either by iterative injections or by continued infusion. Concerning haemodynamic changes, the diastolic blood pressure decreases in propofol group without any deleterious effect for these patients. Recovering time is the same in the two groups. The time for recovering memorization is significantly shorter in the propofol group. The use of these two drugs is fully justified in an emergency situation with preference for propofol in case of preoperative haemodynamic stability.

[Propofol in emergency anesthesia]. / Le propofol en anesthésie d'urgence.

Thirty-two patients (14 women and 18 men) whose age ranged between 15 and 76 were admitted on an emergency and anesthetized with propofol in view of various surgical interventions (9 appendectomies, 9 fractures, 5 wound healing, 6 abscess incisions, 2 corneal grafts and one complex trauma surgery) undergone 24 hours after their admission. Premedication included hydroxyzine 1.5 mg.kg-1, atropine sulfate 0.5 to 0.75 mg and pethidine 1 mg.kg-1 according to pain intensity and initial pathology. Narcosis was induced by 2.5 mg.kg-1 propofol injected intravenously. Propofol was then administered continuously at a dose of 9 mg.kg-1 in the first hour and of 4.5 mg.kg-1.h-1 in the following hours for 28 of the patients. Four patients undergoing short operations were given additional injections of one third of the initial dose. Analgesia and myorelaxation were obtained with fentanyl (0.16 +/- 0.06 mg) and vecuronium (9.3 +/- 4 mg). Narcosis proved to be very efficient. The side effects observed (13% myoclonia, 6% rash, 6% bradycardia, 0.3% pains at the time of injection) were similar to those quoted in the literature. Blood pressure stabilized after a short slight depression (13% to 18% of the standard values). Pulse remained regular. We can thus say that propofol is a good hypnotic drug for emergency anesthesia provided that its contra-indications especially shocks of cardiac or septic origin and hypovolemia, are carefully respected.(ABSTRACT TRUNCATED AT 250 WORDS)