Propofol-based Fast-track for Ambulatory Surgery
Siriwan Jirasiritham MD*, Kamthorn Tantivitayatan MD*, Sopon Jirasiritham MD**
Affiliation : * Department of Anesthesiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University ** Department of Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University
The purpose of this study was to provide data of propofol-based total intravenous anesthesia (TIVA) for ambulatory surgery in developing a fast-track technique. One hundred and forty-two patients scheduled for elective surgery were studied : mean (SD) age 42.21(16.23) years, male to female 72 : 70, mean (SD) body weight 60.75 (11.67) kg and American Society of Anesthesiologists (ASA) physical status I / II/ III 66/38/38. Mean (SD) thiopental induction 225 (55.69) mg was maintained with mean (SD) propofol 199.64 (86.26) mg for mean (SD) anesthetic time 29.02 (11.21) minutes. Various narcotics were used : fentanyl 73.48 + 24.38 µg for 123 cases, morphine 3.27 + 1.10 mg for 10 cases, remifentanil 492 + 105.26 µg for 7 cases and pethidine 23.33 + 2.88 mg for 2 cases. Midazolam was given 2.70 + 1.05 mg. Patients were positioned in supine, lithotomy or lateral decubitus. One-fourth were PS III with a diagnosis of chronic renal failure and renal transplants coming for incision and drainage of perianal abscess. The mean (SD) wake-up time was 36.02 (17.69) seconds. Only one case (chronic renal failure) had severe hypotension after induction. Anesthetic agents and ideas of fast-track anesthesia were discussed.
Keywords : Propofol, Fast-track, Ambulatory, Total intravenous anesthesia, TIVA
