Combined anesthesia has been associated with less sedation, earlier ambulation, higher pulmonary flow rates, improved oxygenation, blunting of stress response and better control in the postoperative period than general anesthesia.
Total intravenous anesthesia has many advantages compared with inhalation anesthesia, but also has several disadvantages such as hypertension, inappropriate anesthetic depth, delayed recovery and emergence delirium.
For improvement of this problems, the authors tried epidural anesthesia combined with continuous intravenous infusion of propofol which is a short acting intravenous anesthetic and has characteristics of rapid and clear-headed recovery.
Fifty-three patients undergoing elective thoracic operation were randomly assigned to receive anesthesia with N2O-O2-enflurane (n=23), epidural anesthesia combined with N2O-O2-propofol infusion (3 mg/kg/hr, m=15), or epidural anesthesia combined
with
medical air-O2-propofol infusion (6 mg/kg/hr, n=15).
We studied the hemodynamic changes and occurrence of awareness and recovery time on those three groups.
Although there were significant changes in the hemodynamics among the groups except CVP, but all values were within normal limit and there were no difference in the recovery time.
We concluded that epidural anesthesia with medical air-O2-propofol infusion (6 mg/kg/hr) is acceptable alternative method for thoracic surgery.
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