Browse > Article

Comparative randomized study of propofol target-controlled infusion versus sevoflurane anesthesia for third molar extraction  

Chung, Patrick K (Concord Repatriation General Hospital)
Dhanrajani, Parmanand (HCF Dental Centre)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.18, no.3, 2018 , pp. 169-175 More about this Journal
Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.
Propofol; Sevoflurane; Target-Controlled Infusion;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Raeder J, Gupta A, Pedersen FM. Recovery characteristics of sevoflurane- or propofol-based anaesthesia for day-care surgery. Acta Anaesthesiol Scand 1997; 41: 988-94.   DOI
2 Matsuura H, Inoue S, Kawagucji M. The risk of postoperative nausea and vomiting between surgical patients received propofol and sevoflurane anesthesia: A matched study. Acta Anaesthesiol Taiwan 2016; 54: 114-20.   DOI
3 Pokkinen SM, Yli-Hankala A, Kalliomaki ML. The effects of propofol vs. sevoflurane on post-operative pain and need of opioid. Acta Anaesthesiol Scand 2014; 58: 980-5.   DOI
4 Absalom AR, Mani V, De Smet T, Struys MM. Pharmacokinetic models for propofol -defining and illuminating the devil in the detail. Br J Anaesth 2009; 103: 26-37.   DOI
5 Russell D, Wilkes MP, Hunter SC, Glen JB, Hutton P, Kenny GNC. Manual compared with target-controlled infusion of propofol. Br J Anaesth 1995; 75: 562-6.   DOI
6 Glen JB. The development of 'Diprifusor': a TCI system for propofol. Anaesthesia 1998 (53 Suppl 1): 13-21.
7 Gray JM, Kenny GN. Development of the technology for 'Diprifusor' TCI systems. Anaesthesia 1998 (53 Suppl 1): 22-7.   DOI
8 Bharti N, Chari P, Kumar P. Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery. Saudi J Anaesth 2012; 6: 380-4.   DOI
9 Godet G, Watremez C, Kettani CE, Soriano C, Coriat P. A comparison of sevoflurane, target-controlled infusion propofol, and propofol/isoflurane anesthesia in patients undergoing carotid surgery; a quality of anesthesia and recovery profile. Anesth Analg 2001; 93: 560-5.   DOI
10 Shimonov M, Ezri T, Blecher M, Cherniak A, Azamfirei L. Hemodynamic effects of sevoflurane versus propofol anesthesia for laparoscopic radiofrequency ablation of liver tumours. S AFR J Anesth Analg 2006; 12: 149-52.
11 Akkurt BC, Temiz M, Inanoglu K, Aslan A, Turhanoglu S, Asfuroglu Z, et al. Comparison of recovery characteristics, postoperative nausea and vomiting, and gastrointestinal motility with total intravenous anesthesia with propofol versus inhalation anesthesia with desflurane for laparoscopic cholecystectomy: a randomized controlled study. Curr Ther Res Clin Exp 2009; 70: 95-103.
12 Watson KR, Shah MV. Clinical comparison of 'single agent' anaesthesia with sevoflurane versus target controlled infusion of propofol. Br J Anaesth 2000; 85: 541-6.   DOI
13 Fahy BG, Chau DF. The technology of processed electroencephalogram monitoring devices for assessment of depth of anesthesia. Anesth Analg 2018; 126: 111-7.   DOI
14 Ellerkmann RK, Soegle M, Riese G, Zinserling J, Wirz S, Hoeft A, et al. The Entropy Module and Bispectral Index as guidance for propofol-remifentanil anaesthesia in combination with regional anaesthesia compared with a standard clinical practice group. Anaesth Intensive Care 2010; 38: 159-66.   DOI
15 Hocker J, Tonner PH, Bollert P, Paris A, Scholz J, Meier-Paika C, et al. Propofol/ remifentanil vs. sevoflurane/ remifentanil for longlasting surgical procedures: a randomized controlled trial. Anaesthesia 2006; 61: 752-7.   DOI
16 Smith I, Thwaites AJ. Target-controlled propofol vs. sevoflurane; a double-blind, randomized comparison in day-case anaesthesia. Anaesthesia 1999; 54: 745-52.   DOI