EARLY AND LATE RECOVERY AFTER MAJOR ABDOMINAL-SURGERY - COMPARISON BETWEEN PROPOFOL ANESTHESIA WITH AND WITHOUT NITROUS-OXIDE AND ISOFLURANE ANESTHESIA

A comparison was made between early and late recovery after major abdo minal surgery under intravenous anaesthesia with propofol (with and wi thout nitrous oxide) or inhalational anaesthesia with isoflurane. Sixt y patients were randomly allocated to one of three forms of anaesthesi a: propofol, propofol/nitrous oxide, or isoflurane/nitrous oxide anaes thesia. All received fentanyl and vecuronium. Recovery was monitored d uring the first 2 h after extubation and on days 1, 2, 3, 7 and 30 aft er surgery. Every 30 min during the first 2 postoperative hours, the S teward recovery scale, sedation, orientation, collaboration, and compr ehension were assessed by a blinded observer. Psychomotor function was evaluated by computerised simple reaction time and finger tapping spe ed in 32 patients. A scale of symptoms and mood check list were filled in by 35 patients on days 1, 2, 3, 7 and 30. The preoperative values for all tests were collected 1-4 days before surgery. The time between end of surgery and extubation was longer in the propofol group, but e arly and late recovery of psychomotor function were similar in the thr ee groups. Patients anaethetised with isoflurane reported more vegetat ive symptoms than those who received propofol (P < 0.03). The addition of nitrous oxide to propofol did not change the reported degree of sy mptoms. The difference in vegetative symptoms between groups was most obvious on day 7. Patients anaesthetised with propofol reported better subjective control (P < 0.02) and were more socially oriented (P < 0. 05) than patients anaesthetised with isoflurane. We conclude that earl y recovery was similar in the three groups. Patients anaesthetised wit h propofol reported fewer late symptoms and better mood after operatio n than those anaesthetised with isoflurane. The addition of nitrous ox ide did not affect the results.