CRNA : the clinical forum for nurse anesthetists
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anesthesia with a continuous propofol-alfentanil infusion.
A total intravenous anesthetic using propofol and alfentanil was evaluated to determine if it would provide a shorter recovery-room stay than a more traditional balanced anesthetic using isoflurane and alfentanil. Forty-three ASA I or II patients between 17 and 50 years of age undergoing major abdominal or orthopedic procedures were studied. The propofol group received alfentanil 50 mg/kg followed by propofol 1 mg/kg for anesthesia induction. ⋯ One episode each of intraoperative awareness and delayed eye opening occurred in the propofol group. Total intravenous anesthesia using propofol and alfentanil is just as effective as a balanced inhalation anesthetic and provides equally rapid recovery. However, practitioners are cautioned to include an amnestic adjuvant when using propofol as the sole anesthetic agent.
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The anesthetist must be aware of anesthesia implications for the surgical patient who is taking prescribed psychotropic medications. The number of patients taking psychotropic medications who present for surgery is increasing. Psychotropic medications combined with anesthesia can produce serious complications. This article reviews commonly known psychotropic medications and introduces the anesthetic implications of two new drugs, fluoxetine and buspirone.