Key result
Propofol resulted in a significantly longer mean time to initial awakening compared to thiopentone during elective cardioversion, with no significant differences in energy requirements.
Why the study?
Does propofol compared to thiopentone affect energy requirements or time to awakening in patients undergoing elective cardioversion for atrial fibrillation?
RCT (n=44)
Alternating assignment
Does propofol compared to thiopentone affect energy requirements or time to awakening in patients undergoing elective cardioversion for atrial fibrillation?
Propofol is a viable alternative to thiopentone for anaesthesia during elective cardioversion, despite a slightly longer time to initial awakening.
Answers are grounded in this paper and cite their sources.
May prolong awakening with propofol; leaves open optimal agent selection pending randomized trials.
A 1-year population of anaesthesias for cardioversion of supraventricular tachyarrhythmias was studied. Propofol and thiopentone were used alternately for every other procedure, and the anaesthetic-, and monitoring procedures were prospectively standardized. Twenty-one thiopentone- and 23 propofol-anaesthetized patients, who had been subjected to elective cardioversions of atrial fibrillation were compared, particularly regarding possible differences in the energy requirements for cardioversion and in the time intervals to initial awakening. There were no significant differences between the two drugs in the maximum systolic blood pressure drop, in the total mean energy requirements per kg bodyweight, or in the distribution of the number of patients over the various energy levels needed for restoration of sinus rhythm. Somewhat unexpectedly, however, the mean time interval to initial awakening was significantly longer in the propofol-anaesthetized group. Apart from this minor drawback, propofol proved to be as useful an anaesthetic agent as thiopentone for the cardioversion procedure, and may be considered as an alternative drug in selected cases.
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Sternlo et al. (1991) conducted an RCT in Atrial fibrillation (n=44). Propofol vs. Thiopentone was evaluated on Energy requirements for cardioversion and time intervals to initial awakening. Propofol resulted in a significantly longer mean time to initial awakening compared to thiopentone during elective cardioversion, with no significant differences in energy requirements.
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