COMPARISON OF PROPOFOL AND METHOHEXITAL CONTINUOUS-INFUSION TECHNIQUES FOR CONSCIOUS SEDATION

Purpose: Methohexital and propofol have been shown to be effective age nts for continuous intravenous infusion to produce:conscious sedation during oral surgical procedures. The current study was conducted to co mpare these techniques for intraoperative cardiopulmonary stability, p atient cooperation, amnesia, comfort, recovery time, and postoperative nausea and vomiting. Methods: Seventy ASA Class I or Class II patient s between the ages of 18 and 40 years, scheduled for surgical extracti on of impacted third molars, were entered into the study. Thirty-five patients were assigned to group A (methohexital) and 35 were assigned to group B (propofol). Intravenous sedation was accomplished using pre medication with 1.5 mu g/kg of fentanyl and 0.05 mg/kg of midazolam fo llowed by the continuous infusion:of methohexital or propofol at a rat e of 50 mu g/kg/min. The infusion was then titrated to 100 mu g/kg/min to accomplish a level of sedation in which the eyes were closed and t he patients were responsive to verbal commands. Subjects ere monitored for variability of heart rate, blood pressure, oxygen saturation, amn esia, comfort, cooperation, nausea and vomiting, and recovery time bas ed on cognitive, perceptual, and psychomotor tests. Results: There was no statistical difference between the two medication groups except fo r heart rate, which was found to increase by 11 beats/min for group A and only three beats/min in group B. Conclusion: A continuous infusion technique using either methohexital or propofol <50 to 100 mu g/kg/mi n) was found to be safe and effective, with no clinically significant differences in cooperation, cardiopulmonary stability, recovery time, amnesia, comfort, and the incidence of nausea or vomiting. However, th e cost-effectiveness of methohexital is superior to that of propofol.