Abstrato

Clinical comparison of induction with inhalational sevoflurane versus intravenous propofol for perioperative anesthetics in adult: a randomized clinical trial

Chunshan Dong*, Peng Sun, Junma Yu, Jun Zhang & Chao Wu

Background: The introduction of target controlled infusion with propofol and the use of vital capacity inhalation with sevoflurane has led to the rediscovery of ‘optimal’ induction conditions. Objective: To compare sevoflurane and propofol as induction agents, focusing on their impact on haemodynamic stability and anesthetic consumption used during anesthesia maintenance as well as recovery characteristics. Methods: Sixty patients of physical status according to the American Society of Anesthesiologist (ASA) scale of I-II, (25- 65 years) undergoing selective lumbar spondylodesis were randomized into two anesthesia induction groups: target control, propofol infusion or vital capacity inhalation with 8% sevoflurane. Patients subsequently underwent muscular paralysis and intubation, followed by anesthesia maintenance with propofol/remifentanil. Main outcome measure: An independent observer recorded the time to the target depth of anesthesia using the Narcotrend index, hemodynamic stability, and overall anesthetic consumption. Results: Hemodynamic stability was maintained and comparable between both groups. A vital capacity inhalation with 8% sevoflurane resulted in a significantly shorter induction time to target anesthesia depth than the target controlled infusion with propofol but was associated with a higher incidence of hypoventilation. The amount of propofol/ remifentanil needed for anesthesia maintenance was substantially less in patients induced with sevoflurane compared to those induced with propofol. Conclusion: The vital capacity inhalation with 8% sevoflurane was comparable to target control infusion with propofol with respect to the speed of induction, smooth anesthesia depth, and amount of anesthetic consumption during maintenance.