Propofol versus thiamylal-enflurane anesthesia for outpatient laparoscopy

Study Objective: To determine whether propofol anesthesia differs from thiamylal-enflurane anesthesia in induction characteristics, intraoperative hemodynamics, post-operative side effects, and postoperative psychomotor function recovery. Design: A randomized, double-blind, two-group study. Setting: A large university hospital with gynecologic outpatient operations performed in an integrated operating room suite. Patients: Sixty adult women (ASA physical status I or II) undergoing an outpatient gynecologic laparoscopic operation with an anesthesia time of approximately 60 minutes. Interventions: No pharmacologic premedication. Pretreatment with intravenous droperidol 0.6 mg and sufentanil 0.2 μg/kg before induction of anesthesia. Anesthesia was induced with either thiamylal 4 mglkg (Group 1) or propofol 2.5 mglkg (Group 2). Anesthesia was maintained with either nitrous oxide (N₂O) and enflurane, 2-0.5% inspired concentrations; (Group 1) or with a continuous infusion of propofol 200-100 μg/kg/min and N₂O (Group 2). Measurements and Main Results: In psychomotor function tests (Trieger dot test and p-deletion test) administered preoperatively and postoperatively, no difference was found between the groups. No difference was found in induction time, although significantly more patients reported pain after the propofol injection, or in intraoperative hemodynamics (mean arterial pressure and heart rate). Immediate recovery time (emergence from anesthesia) and intermediate recovery time (ambulation, oral intake, and discharge time) were significantly shorter after propofol anesthesia. Fewer postoperative side effects, such as nausea and vomiting, were reported after propofol anesthesia. Conclusions: Induction and maintenance of anesthesia with propofol were comparable to those with thiamylal-enflurane, except patients experienced more pain on injection after propofol. Both immediate and intermediate recovery were more rapid after opofol anesthesia compared with enflurane-based anesthesia.