PROPOFOL AND ALFENTANIL TOTAL INTRAVENOUS ANESTHESIA - A COMPARISON OF TECHNIQUES FOR MAJOR THORACIC-SURGERY

Background: Previous work has highlighted the disadvantages of propofo l as a sole agent for total intravenous anaesthesia (TIVA). This rando mised study investigated three combinations of propofol and alfentanil as TIVA for major thoracic surgery. Methods: In 73 patients undergoin g elective thoracic surgery, anaesthesia was conducted either with sod ium thiopentone induction and inhalational maintenance (incorporating isoflurane) or with TIVA using propofol with alfentanil (by infusion a t one of two rates or in incremental doses). Vital signs and recovery characteristics were recorded. Results: There were no significant diff erences in heart rate or blood pressure between groups during either i nduction or maintenance. Depth of anaesthesia was controlled satisfact orily in all groups. Recovery characteristics were similar between tre atment groups, although there was a trend towards earlier orientation the group which received the highest infusion rate of alfentanil. Conc lusion: Continuous infusions of propofol and alfentanil provide safe a nd reliable TIVA for major thoracic surgery. TIVA was found to be a sa tisfactory technique in more elderly patients than previously describe d. The higher of the two alfentanil infusion rates may result in a bet ter combination of propofol and alfentanil with respect to recovery ti mes than the lower.