PROPOFOL-BASED ANESTHESIA AS COMPARED WITH STANDARD ANESTHETIC TECHNIQUES FOR MIDDLE-EAR SURGERY

OBJECTIVE: To determine whether a totally intravenous technique with p ropofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery. DESIGN: Prospective randomized study. S ETTING: Inpatient otolaryngology service at a university medical cente r. PATIENTS: Physical status 1 and 2 nonobese patients with no signifi cant history of diabetes, chronic cholecystitis, neuropathy, or neurom uscular disorders that could produce delayed gastric emptying, One hun dred two patients were admitted to the study and randomly divided into three equal groups. INTERVENTIONS: Intravenous thiopental, 5 mg/kg, w as administered for induction of anesthesia followed by 60% air/O-2 wi th isoflurane, 1% to 2% end tidal, for maintenance anesthesia (group 1 ). The same anesthetic with the addition of droperidol, 25 mu g/kg, wa s given after induction (group 2). Propofol, 2 mg/kg, was administered intravenously for induction of anesthesia and followed by propofol, 5 0 to 250 mu g/kg/min, for maintenance anesthesia. All groups received fentanyl, 3 mu g/kg intravenously, offer induction. MEASUREMENTS AND M AIN RESULTS: Surgical duration, induction, maintenance, and total anes thesia times were recorded together with eye opening and extubation. I ntergroup comparisons of postoperative nausea, vomiting, and pain, and recovery scores, we made by use of the Steward system. Patients recei ving propofol, compared with the isoflurane-only group, had significan tly less nausea (4/34 vs 12/34 patients, respectively; p < 0.05) and a s vomiting (2/34 vs 8/34 patients, respectively: p < 0.05). Immediate recovery scores were significantly better for propofol compared with t he isoflurane-droperidol group. Recovery scores at 30 minutes were als o faster with propofol compared with isoflurane or isoflurane-droperid ol (5.7 +/- 0.1 vs 5.1 +/- 0.2 and 5.2 +/- 0.2; p < 0.05).