EARLY AND LATE RECOVERY AFTER MAJOR ABDOMINAL-SURGERY - COMPARISON BETWEEN PROPOFOL ANESTHESIA WITH AND WITHOUT NITROUS-OXIDE AND ISOFLURANE ANESTHESIA
Sh. Kalman et al., EARLY AND LATE RECOVERY AFTER MAJOR ABDOMINAL-SURGERY - COMPARISON BETWEEN PROPOFOL ANESTHESIA WITH AND WITHOUT NITROUS-OXIDE AND ISOFLURANE ANESTHESIA, Acta anaesthesiologica Scandinavica, 37(8), 1993, pp. 730-736
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.