Co-induction in ambulatory anesthesia

Abstract

BACKGROUND: Co-induction in anesthesia is very useful: synergistic effects of two inductional drugs may lower the dose regimen and the incidence of adverse effects. The aim of this study was to investigate and compare two anesthesiological techniques for short-lasting gynecological procedures in outpatient anesthesia. A total of 80 patients scheduled for surgical termination of pregnancy were randomly assigned into two equal groups--control and co-induction group. METOHDS: The first group of patients received atropine 0.5 mg i.v., alfentanil 0.5 mg i.v. and propofol as a fractionated i.v. bolus until the loss of eyelash reflex. The second group received atropin 0.5 mg, alfentanil 0.5 mg, midazolam 3 mg and propofol in the same manner as the first group. Anesthesia was maintained with propofol increments. Cardiovascular parameters, parameters of post anesthesia recovery and the adverse effects were registered. RESULTS: In patients receiving midazolam inductional dose of propofol was significantly lower, whereas cardiovascular parameters were not significantly different. The recovery after anesthesia was slightly longer after co-induction, but it was not of great clinical significance. The reduction of the adverse effects was found in the co-induction group. CONCLUSION: The results of the study showed that co-induction of midazolam-propofol in comparison with propofol alone for outpatient anesthesia had the following advantages: the reduction of propofol dose, better quality of anesthesia and the reduction of the adverse effects. Recovery was faster in the group that didn't receive midazolam, but it was not of great clinical significance. The conclusion is that co-induction with the combination midazolam-propofol has the advantage in outpatient procedures.