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Anaesthesia for day case excisional breast biopsy: propofol–remifentanil compared with sevoflurane–nitrous oxide

Published online by Cambridge University Press:  01 June 2008

J.-Y. Hong ,
Y. S. Kang  and
H. K. Kil
J.-Y. Hong*
Affiliation:
Yonsei University College of Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Department of Anesthesiology and Pain Medicine, Seoul, South Korea
Y. S. Kang
Affiliation:
Yonsei University College of Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Department of Anesthesiology and Pain Medicine, Seoul, South Korea
H. K. Kil
Affiliation:
Yonsei University College of Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Department of Anesthesiology and Pain Medicine, Seoul, South Korea
*
Correspondence to: Jeong-Yeon Hong, Department of Anesthesiology, Severance Hospital, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mails: jenyhongg@hanmail.net, jenyhongg@yumc.yonsei.ac.kr>; Tel: +82 2 2228 2427; Fax: +82 2 312 7185
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Summary

Background and objective

A randomized and prospective study was performed to compare anaesthetic characteristics and stress hormone responses of two anaesthetic techniques.

Methods

Forty-two patients undergoing day case excisional biopsy of breast mass were randomly assigned to receive propofol–remifentanil or sevoflurane–N2O. Anaesthesia was induced and maintained either with sevoflurane and 50% N2O in oxygen or with target-controlled remifentanil and propofol in 50% oxygen and air. Anaesthetic depth was monitored by the bispectral index.

Results

The times for induction (2.9 vs. 1.7 min) and for laryngeal mask insertion (5.7 vs. 3.3 min) were longer in the sevoflurane–N2O group than in the propofol–remifentanil group. However, apnoea (57.1% vs. 9.5%) and bradycardia (23.8% vs. 0%) were more prevalent with propofol–remifentanil. In the sevoflurane–N2O group, the emergence times to a verbal response (10.6 vs. 3.7 min), to extubation (11.8 vs. 4.0 min) and to orientation (14.7 vs. 4.8 min) were longer than in the propofol–remifentanil group. There were significantly more nausea (38.1% vs. 4.8%) and vomiting (19.2% vs. 0%) in the sevoflurane–N2O group than in the propofol–remifentanil group. The time to discharge was similar although there was less postoperative pain in the sevoflurane–N2O group. There were no differences in the perioperative cortisol responses in the two groups.

Conclusions

Smoother induction of anaesthesia was seen with sevoflurane–N2O. Propofol–remifentanil showed a quicker emergence with less nausea/vomiting. There were similar perioperative cortisol responses in the two anaesthetic techniques.

Keywords

ANAESTHETIC GENERALANAESTHESIA INTRAVENOUSPROPOFOLREMIFENTANILSEVOFLURANENITROUS OXIDE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 6 , June 2008 , pp. 460 - 467
Copyright
Copyright © European Society of Anaesthesiology 2008

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