RESUMEN
It was confirmed that even 10 minutes long general anesthesia necessary for surgery can cause postoperative morbidity. This fact is of the utmost importance for the choice of anesthetics, especially when the operation is to take place in out-patient conditions. The aim of this study was to compare clinical efficacy, tolerability and adverse effects of thiopental, etomidate and propofol. The study comprised 165 out-patients scheduled for legal abortion under general intravenous anaesthesia. Patients were randomly divided into three groups. In patients from the first group (n = 53) anesthesia was induced with thiopental 5 mg/kg, in the second group (n = 54) with etomidate 0.3 mg/kg, and in the third group (n = 58) with propofol 2.5 mg/kg. Blood pressure, heart rate and adverse effects were monitored during anesthesia and operation and immediately thereafter. The best quality of anesthesia and the best working conditions of gynaecologist were after the use propofol, then after thiopental, followed by etomidate. Frequency of adverse effects was significantly greater after anesthesia with etomidate (26.06%), when compared to propofol (9.69%) and thiopental (9.09%). Immediately after induction to anesthesia, adverse effects were found after the use of thiopental, etomidate and propofol in 7.5%, 9.07% and 5.1% of patients, respectively. During anaesthesia, adverse effects were registered in 5.6%, 37.03% and 5.1% of patients in thiopental, etomidate and propofol group, respectively. In the same three groups, frequency of adverse effects in the immediate post-anesthetic recovery period was 15.09%, 62.09% and 17.06%, respectively. It could be concluded that in this study, out of the three anesthetics investigated, propofol had the greatest clinical efficacy and tolerability and the lowest incidence of adverse effects.
Asunto(s)
Anestésicos Intravenosos/efectos adversos , Aborto Inducido , Adulto , Periodo de Recuperación de la Anestesia , Anestesia General , Anestesia Intravenosa , Anestesia Obstétrica , Etomidato/efectos adversos , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Propofol/efectos adversos , Tiopental/efectos adversosRESUMEN
After reviewing the results of published comparative studies by numerous authors we have noticed that propofol, among the other intravenous anesthetics, has the strongest cardiovascular effects. The aim of this study was to compare the cardiovascular effects of induction doses of propofol, etomidate and thiopentone. A total of 165 female patients were randomly divided into three groups, and each one received a different anesthetic agent: propofol 2.5 mg/kg (n = 58), etomidate 0.3 mg/kg (n = 54) or thiopentone 5 mg/kg (n = 53). the patients were scheduled for abortion (gravidity up to 12 weeks of gestation) in out-patient conditions. Indirect registration of systolic and diastolic blood pressure and palpatory registration of radial pulse was performed: on admittance, immediately before the induction of anaesthesia and 2, 5 and 10 min thereafter. Following the administration of induction dose of propofol, a significantly greater decrease of systolic and diastolic blood pressure was observed then after the administration of etomidate or thiopentone. Slowing down of radial pulse was also more marked in propofol, then in etomidate or thiopentone group. The results of our study had shown that the induction dose of propofol had stronger effects on cardiovascular system, compared to the induction doses of etomidate or thiopentone.
Asunto(s)
Anestesia Intravenosa , Anestésicos Intravenosos/farmacología , Hemodinámica/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Etomidato/farmacología , Femenino , Humanos , Propofol/farmacología , Pulso Arterial , Tiopental/farmacologíaRESUMEN
All the anesthetics used for induction of anesthesia in cesarean section cross the placenta and can induce neonatal depression. The aim of this investigation was to compare intravenous anesthetics propofol and thiopentone as induction agents in patients scheduled for elective cesarean section and studying of their affection of mothers and new-born children. A total of 40 female patients were scheduled for elective cesarean section. They were randomly divided in two equal groups, each of them was to receive different anesthetic: propofol 2.5 mg/kg (n = 20) or thiopentone 5 mg/kg (n = 20). Orotracheal intubation was facilitated with suxamethonium 1.5 mg/kg. Anesthesia was maintained by controlled ventilation with mixture of nitrous oxide and oxygen (50%:50%) and pancuronium 4 mg. After extraction of the foetus, anesthesia was maintained with mixture of nitrous oxide and oxygen (70%:30%), fentanyl 0.15-0.20 mg and pancuronium 1-2 mg. At the end of operation, competitive neuromuscular block was antagonised with neostigmine. There were no significant differences among the groups, as regards age, body weight and height, ASA classification grade and week of gestation. Following induction of anesthesia, a significantly greater decrease of blood pressure and heart rate was found in the propofol group, when compared with the patients in thiopentone group. During the induction and maintenance of anesthesia, the frequency of adverse effects was greater in thiopentone, than in propofol group (6/20 versus 2/20 patients). There was no significant difference between the groups when induction-delivery (l-D) interval was concerned. The new-borns from the propofol group had significantly higher Apgar score in the 1st minute (8.35) and 5th minute (9.25), than the new-borns in thiopentone group (7.90 and 8.90, respectively).
Asunto(s)
Anestesia Obstétrica , Anestésicos Intravenosos/farmacología , Cesárea , Propofol/farmacología , Tiopental/farmacología , Adulto , Puntaje de Apgar , Presión Sanguínea/efectos de los fármacos , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Recién Nacido , EmbarazoRESUMEN
This article briefly reviews biochemistry of oxygen free radical production, physiological mechanisms of anti-free radical tissue protection and the pathological processes which, at least partly, depend on free radical production and lipid peroxidation. Special accent is put on therapeutic implications of numerous experimental findings in this scientific field. The aim of this paper is to call attention of the physicians to the entirely new concept of pathogenesis of many serious diseases, which affords new therapeutic opportunities.