Low-flow anaesthesia with sevoflurane for endoscopic abdominal surgery

Overview

15 patients (6 men) aged 59±11,9 years, BMI 29±5,4, ASA 2±0,63 indicated for endoscopic cholecystectomy (12) or herniotomy (3) werepremedicated with diazepam 10 mg PO. The patients were induced with propofol (170±35 mg), fentanyl (0,2 mg) and mivacurium (13±2,5 mg). Aftershort time allowed for equilibration, sevoflurane was administered at 1 l/min fresh gas flow mixture with FA/FI over 0,9 in N2O/O2, while relaxationwas maintained with mivacurium (35±17 mg). Systolic arterial pressure (mmHg) at 13 th minute dropped from 151±23,6 to 98±26,1 (65% of originalvalues), diastolic pressure decreased from from 84±12,3 to 60±18,9 (71%) and heart rate (beats/min.) from 78±18,28 to 57±13,4 (73%).Pharmacologic intervention (atropin in 5 cases, ephedrin in 1 case) was used in 6 patients (40%), in 5 cases in hypertensive subjects on therapy withACE-I. Three patients were given tramadol in early postoperative phase; nausea was observed in one case. Recovery from anaesthesia was standard.Times elapsed were as follows: to extubation 7±4,2 mins, to eye-opening 10±3,7 mins and to self-orientation 12±3,9 mins. the evaluation of influencesof gender, ASA, BMI and duration of anaesthesia on recovery parameters follows.

Key words:
inhalation anaesthesia – recovery from anaesthesia – propofol – postoperative pain