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  • Title: Sevoflurane/propofol coadministration provides better recovery than sevoflurane in combined general/epidural anesthesia: a randomized clinical trial.
    Author: Liang C, Ding M, Du F, Cang J, Xue Z.
    Journal: J Anesth; 2014 Oct; 28(5):721-6. PubMed ID: 24557087.
    Abstract:
    PURPOSE: A classic general anesthesia is performed by induction with an intravenous hypnotic (such as propofol) and maintenance with a volatile anesthetic (such as sevoflurane). The aim of the present study was to compare the effects of a propofol/sevoflurane maintenance regimen with that of a sevoflurane regimen on recovery profiles. METHODS: One hundred and sixty patients, who were ASA 1 or 2, 45-65 years of age, and scheduled for elective gastrointestinal surgery under combined general/epidural anesthesia, were allocated randomly to receive the sevoflurane maintenance regimen (group S, n = 80) or sevoflurane/propofol regimen (group SP, n = 80). After induction, anesthesia was maintained with sevoflurane in group S and sevoflurane with propofol (1.2 μg/ml target plasma concentration) in group SP. Bispectral index (BIS) values were maintained within 40-60 during the maintenance. Time to extubation, incidence of serious coughing and agitation, and other recovery characteristics were evaluated during emergence. RESULTS: The time to awakening and extubation in group SP were 7.2 ± 2 min and 8.0 ± 1.8 min, respectively, which were shorter than those results in group S (12.3 ± 1.5 and 12.8 ± 1.6 min, respectively) (P < 0.05). The incidence of serious coughing and agitation in SP (30% and 25%) was lower than that of group S (68% and 53%) (P < 0.05). BIS value, pain score, requirements of analgesics and antiemetics in the PACU, and length of stay in the PACU were similar in the two groups. CONCLUSIONS: Compared to sevoflurane maintenance, coadministration of propofol and sevoflurane provides faster awakening and extubation with a low incidence of emergence coughing and agitation.
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