Target-controlled infusion of propofol reduced the duration of hypotension compared to sevoflurane (1.9 vs 4.7 min, P<0.05) and bradycardia compared to propofol bolus (0.1 vs 2.5 min, P<0.05).
RCT
Does sevoflurane or TCI propofol improve hemodynamic stability and recovery compared to propofol/isoflurane in patients undergoing carotid endarterectomy?
TCI propofol provides better hemodynamic stability regarding the duration of hypotension and bradycardia compared to sevoflurane or propofol bolus/isoflurane during carotid endarterectomy.
In a prospective randomized study in patients undergoing carotid endarterectomy, we compared the hemodynamic effects, the quality of induction, and the quality of recovery from a hypnotic drug for the induction of anesthesia with sevoflurane, a target-controlled infusion (TCI) of propofol, or propofol 1.5 microg/kg followed by isoflurane. All patients were premedicated with midazolam and received sufentanil 0.4 microg/kg at induction. The induction of anesthesia was associated with a decrease in arterial blood pressure in all groups, but this was least pronounced in the Sevoflurane group. There were similar a number of episodes of hypotension, hypertension, and tachycardia among groups, but the incidence of bradycardia was less in the TCI group (P < 0.05) compared with the other groups. The duration of episodes of hypotension was shorter (P < 0.05) in the TCI Propofol group (1.9 +/- 2.3 min) compared with the Sevoflurane group (4.7 +/- 3.6 min). The duration of episodes of bradycardia was significantly lower (P < 0.05) in the TCI Propofol group (0.1 +/- 0.5 min) in comparison with the Propofol Bolus group (2.5 +/- 3.9 min). Similar doses of vasoactive drugs were used in all groups. The induction of anesthesia with sevoflurane was associated with inferior conditions for intubation in comparison with both Propofol groups, although the time to intubation was faster in the Sevoflurane group (P < 0.05). The recovery characteristics were similar in the three groups.
Godet et al. (Sat,) conducted a rct in Carotid endarterectomy. Sevoflurane or target-controlled infusion (TCI) of propofol vs. Propofol followed by isoflurane was evaluated on Hemodynamic effects, quality of induction, and quality of recovery. Target-controlled infusion of propofol reduced the duration of hypotension compared to sevoflurane (1.9 vs 4.7 min, P<0.05) and bradycardia compared to propofol bolus (0.1 vs 2.5 min, P<0.05).