Anestezja wziewna sewofluranem lub dożylna propofolem z zastosowaniem maski krtaniowej do operacji ginekologicznych

Maria Ogonowska-Kobusiewicz¹, Agnieszka Wrońska-Sewruk¹, Michał Kowalczyk¹, Jacek Tomaszewski²

Summary
Background. As short day-case gynaecological surgery does not usually require deep anaesthesia and/or muscle relaxation, we have compared propofol vs. sevoflurane anaesthesia in spontaneously breathing patients. Methods. 77 ASA I and II women, scheduled for short gynaecological procedures, were randomly divided into two groups: Group I: Induction with 2-2.5 mg kg^-1 propofol, followed by 4 mg kg^-1 h^-1 continuous propofol infusion and N₂ O, Group II: Single-breath vital capacity rapid induction with 8% sevoflurane, followed by 1.0-1.5% sevoflurane with N₂ O. In both groups, patients breathed spontaneously via a laryngeal mask airway (LMA). We recorded the time to loss of eyelash reflex, time to LMA insertion, duration of the apnea after induction, recovery time, mean arterial pressure (MAP), heart rate (HR), and number of adverse events. Results. Induction time was similar in both groups. Duration of the post-induction apnea was significantly longer in the propofol group (p<0.04). MAP was significantly lower (p<0.05) during surgery in the sevoflurane group, and HR was lower (p<0.05) in the propofol group before the anaesthesia and at the beginning of surgery. The time to recovery was similar in both groups. Discussion and conclusion. Both anaesthesia regimens were suitable for short gynaecological procedures. Sevoflurane induction was well tolerated, but associated with significant environmental pollution. We regard both methods as safe and effective.

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