Simplified use of mixed propofol and alfentanil for anesthesia in remote locations

Total intravenous anesthesia (TIVA) is a useful technique in precarious sit uations in which anesthesia ventilators and medical gas can be difficult to obtain. The aim of the study is to compare TIVA technique using a simplifi ed infusion scheme for propofol and alfentanil mixed together (45 ml of pro pofol 1% and 2,500 mu g of alfentanil in a 50-ml syringe) with an inhalatio nal anesthetic technique (isoflurane/N2O, sufentanil). Thirty-two American Society of Anesthesiologists physical status I patients undergoing orthoped ic surgery were studied. Intubation conditions and hemodynamic responses to intubation were comparable in the two groups. Only patients receiving TIVA had responses to surgery. In the TIVA group, time to extubation was shorte r (16 +/- 5 vs, 25 +/- 7 minutes) and postoperative requirement for morphin e was lower (6.2% vs. 25%) than in the inhalation group (p < 0.05). TIVA us ing a mixture of propofol and alfentanil is a reliable technique of anesthe sia in patients without multiple injuries.