Postgraduate medical journal
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Propofol as an hypnotic in combination with fentanyl and vecuronium was used for total intravenous anaesthesia in 30 healthy unpremedicated patients undergoing elective surgery scheduled to last no longer than 1 h. Induction with propofol 2 mg/kg and fentanyl 1.875 micrograms/kg resulted in cessation of counting after 39 s and the loss of the eyelash reflex after 57 s. ⋯ During longer procedures there was evidence of accumulation in that propofol utilization rate decreased as the duration of anaesthesia increased. The results obtained are similar to those described with the previous Cremophor formulation although greater variability in induction and recovery times was noted with the emulsion formulation.
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The use of propofol for induction and maintenance of anaesthesia by intermittent bolus injection in 37 patients undergoing body surface operations is described. This technique gave good operating conditions in most of the patients in the series. With an induction dose of 2.5 mg/kg propofol, a dose of 11.25 mg/kg/h was found to be the median dose requirement for maintenance of anaesthesia in this study. This dose will be used to calculate infusion rates for future studies with the drug.
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In younger patients, 2.25 mg/kg is a reliable induction dose of propofol, whereas this level falls to 1.5 mg/kg in older patients. The incidence of hypotension and apnoea is dose-dependent in all patients.
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A standard method (fixed initial dose of 1.25 mg/kg followed by 10 mg every 15 s) for studying the induction dose of propofol showed a marked falling off in requirements in fit unpremedicated patients aged 60 y and over. With this slow technique of administration, side effects were rare, even in the elderly.