Abstract
Background: Ambulatory surgery presents unique challenges for the anaesthetist. About 40- 60% of all surgical procedure could be performed in an out – patient surgery centre. Thiopentone sodium was considered as a standard drug for induction of anaesthesia. For short procedures in day care surgery which requires a quicker and smoother induction as well as smooth and rapid recovery Di-isopropyl Phenol [Diprivan] referred as Propofol is extensively used for induction of anaesthesia.
The aim of the study is to compare the merits and demerits of propofol with that of thiopentone sodium for induction and recovery.
Materials and Materials: This study is conducted among 60 patients who were posted for the minor gynaecological procedure – dilatation and curettage. Out of the 60 patients, 30 patients (Group I) received propofol and 30 patients (Group II) received thiopentone as induction agent. Time of induction, Effects on cardio-vascular & respiratory system, Speed of recovery, Hang over, Street fitness and other side effects were compared.
Results: Time for induction of anaesthesia in group I was 15 seconds at the earliest and 45 seconds as the maximum with a mean of 30.27 seconds. In group II the same was 18 seconds and 45 seconds respectively with a mean of 29.46 seconds. Apnoea lasting for less than 30 seconds was noted in 3 patients [10%] in Group I and the same was in 11 patients [36%] in group II. Incidence of cough was in 2 patients [6.6%] who received thiopentone. No such incidence was noticed in patient receiving propofol. 12 patients [40%] in the propofol group complained of pain whereas it was 5 [16%] in patients who received thiopentone. The mean increase in heart rate at the end of 3 min when compared to pre-induction value was 2 bpm in propofol group when compared to 3.71 bpm of thiopentone group. The mean decrease in mean arterial pressure in propofol group was 9.32 mm Hg and 3.66 mm Hg in thiopentone group at the end of 3 minutes. Recovery time in propofol ranged from 3-16 min with a mean of 8.67 min. In Thiopentone recovery time ranged from 5-23 min with a mean of 10.86 min.
Conclusion: Propofol can be used as an ideal induction agent for day care surgery, keeping in mind the respiratory depression and cardiovascular effect where a judicious and cautions approach and vigilant monitoring is required.
Keywords: Propofol, Thiopentone sodium, Haemodynamic changes, Induction, Recovery
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Corresponding Author
Dr G.Vijaya MD.
Associate Professor, Dept of Anaesthesiology, Government Theni Medical College, Theni, Tamilnadu