| El propofol en emulsión lipídica atenúa menos la regulación de la temperatura corporal que la microemulsión de propofol o sevoflurano en los ancianos. |
| Lipid-emulsion propofol less attenuates the regulation of body temperature than micro-emulsion propofol or sevoflurane in the elderly. Jeong CW, Ju J, Lee DW, Lee SH, Yoon MH. Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 5 Hak 1-dong, Gwangju 501-746, Korea.mhyoon@jnu.ac.kr. Yonsei Med J. 2012 Jan 1;53(1):198-203. doi: 10.3349/ymj.2012.53.1.198. Abstract Purpose: Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. Materials and Methods: In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. Results: The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5±0.6°C, 1.6±0.5°C and 2.3±0.6°C, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. Conclusion: The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol. http://www.eymj.org/Synapse/Data/PDFData/0069YMJ/ymj-53-198.pdf |
| Comparación de los efectos del sevoflurano y propofol sobre la temperature corporal durante cirugía laparoscópica abdominal. |
| Comparison of the effects of sevoflurane and propofol on core body temperature during laparoscopic abdominal surgery. Kwak HJ, Min SK, Yi IK, Chang YJ, Kim JY. Department of Anesthesiology and Pain Medicine, Gachon University of Science and Medicine, Gil Medical Center, Incheon, Korea. Korean J Anesthesiol. 2011 Aug;61(2):133-7. Epub 2011 Aug 23. Abstract BACKGROUND: A decrease in core body temperature caused by heat distribution depends on the anesthetic agent used. The purpose of this study is to investigate the effects of sevoflurane and propofol on core temperature during laparoscopic major abdominal surgery requiring pneumoperitoneum of more than 90 min. METHODS: Fifty adult patients undergoing laparoscopic major abdominal surgery were randomly assigned to either a sevoflurane group (n = 25) or a propofol group (n = 25). In the sevoflurane group, anesthesia was induced with propofol 2 mg/kg, remifentanil 1.0 µg/kg, and maintained with 0.8-2.0 vol% sevoflurane and 0.1-0.2 µg/kg/min remifentanil. In the propofol group, anesthesia was induced with the effect-site concentration of propofol of 5.0 µg/ml and remifentanil 4 ng/ml, and maintained with the effect-site concentration of propofol of 2-3.5 µg/ml and remifentanil 3-5 ng/ml. Core body temperature was measured with an esophageal stethoscope with a temperature sensor after the start of the pneumoperitoneum (baseline) and at 15-min intervals until completion of surgery. RESULTS: During the study period, core temperature was comparable between the two groups. When compared with baseline values, core temperatures in both groups were significantly decreased 45 min after pneumoperitoneum. CONCLUSIONS: This study demonstrated that in patients undergoing prolonged laparoscopic surgery, a decrease in core body temperature during sevoflurane-remifentanil anesthesia was not different than propofol-remifentanil anesthesia, and the incidence of hypothermia of the two groups did not differ. http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-61-133.pdf |
| Propofol en cirugía plástica en oficina |
Propofol in office-based plastic surgery.
Friedberg BL. Volunteer Faculty, Department of Anesthesia, Keck School of Medicine, University of Southern California, Los Angeles, California. Semin Plast Surg. 2007 May;21(2):129-32. Abstract Propofol is the nearly ideal agent for office-based plastic surgery. Among all anesthetic agents, only propofol has the ability to elicit happiness in this special group of patients. Cosmetic surgery patients will tolerate discomfort in preference to postoperative nausea and vomiting. Propofol is a powerful antiemetic agent. Patient safety will not be optimized unless the person responsible for the administration of propofol has airway management skills. Dedicated anesthesia providers are highly skilled in airway management. Although the short half-life of propofol is seductive for a fast-acting, rapid emerging anesthetic, interindividual differences in propofol response make measurement of the target organ (i.e., the brain) with a bispectral index (BIS) monitor very important. BIS levels < 45 for > 1 hour are associated with increased 1-year anesthesia mortality thought to be associated with an inflammatory response. The only currently available way to avoid overmedicating with propofol is to monitor with a level of consciousness monitor like BIS |
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Anestesiología y Medicina del Dolor
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