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CARDIOVASCULAR ANESTHESIA

A Comparison of Sevoflurane, Target-Controlled Infusion Propofol, and Propofol/Isoflurane Anesthesia in Patients Undergoing Carotid Surgery: A Quality of Anesthesia and Recovery Profile

Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France

Address correspondence and reprint requests to Gilles Godet, MD, Département d’Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, 47-83 Bd de l’Hôpital, 75013 Paris, France.

In a prospective randomized study in patients undergoing carotid endarterectomy, we compared the hemodynamic effects, the quality of induction, and the quality of recovery from a hypnotic drug for the induction of anesthesia with sevoflurane, a target-controlled infusion (TCI) of propofol, or propofol 1.5 µg/kg followed by isoflurane. All patients were premedicated with midazolam and received sufentanil 0.4 µg/kg at induction. The induction of anesthesia was associated with a decrease in arterial blood pressure in all groups, but this was least pronounced in the Sevoflurane group. There were similar a number of episodes of hypotension, hypertension, and tachycardia among groups, but the incidence of bradycardia was less in the TCI group (P < 0.05) compared with the other groups. The duration of episodes of hypotension was shorter (P < 0.05) in the TCI Propofol group (1.9 ± 2.3 min) compared with the Sevoflurane group (4.7 ± 3.6 min). The duration of episodes of bradycardia was significantly lower (P < 0.05) in the TCI Propofol group (0.1 ± 0.5 min) in comparison with the Propofol Bolus group (2.5 ± 3.9 min). Similar doses of vasoactive drugs were used in all groups. The induction of anesthesia with sevoflurane was associated with inferior conditions for intubation in comparison with both Propofol groups, although the time to intubation was faster in the Sevoflurane group (P < 0.05). The recovery characteristics were similar in the three groups.

IMPLICATIONS: In patients undergoing carotid endarterectomy, the induction of anesthesia with sevoflurane, target-controlled infusion propofol, or propofol bolus is associated with a decrease in arterial blood pressure. Induction with sevoflurane is associated with inferior but faster conditions for intubation of the trachea. The recovery characteristics were similar in the three groups.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999