TOTAL I.V. ANAESTHESIA WITH PROPOFOL-ALFENTANIL OR PROPOFOL-FENTANYL

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Abstract
In combination with propofol, alfentanil was compared with fentanyl for total i.v. anaesthesia in 29 woman (ASA classes I, II) admitted for elective hysterectomy. Infusion rates of propofol and fentanyl were determined from the literature and from pilot studies, while alfentanil was given according to a computer program. Dosage was: propofol, bolus 1.5 mg kg-1, infusion 9 mg kg-1 h-1 for 10 min and thereafter 6 mg kg-1 h-1; fentanyl, bolus 7.5 .mu.g kg-1, infusion 15 .mu.g kg-1 h-1 reduced successively to 1.8 .mu.g kg-1 h-1; alfentanil, bolus 60 .mu.g kg-1, infusion 240 .mu.g kg-1 h-1 reduced successively to 100 .mu.g min-1. Induction was smooth and maintenance easy to manage in both groups. Plasma concentrations were stable with a ratio of alfentanil to fentanyl of 100:1. Recovery times were equal and short, but recovery tests performed 3 h after operation showed that alfentanil produced a greater effect on ability to concentrate and fine co-ordination.

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