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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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THERAPEUTICAL NOTES  ANESTESIOLOGY


Minerva Anestesiologica 2000 July-August;66(7-8):531-7

language: English

Measuring complexity/level of care and appropriateness of resource use in Intensive Care Units

Zattoni J. 1, Rossi A. 1, Cella F. 1, Ori C. 2, Facco E. 2, Giron G. P. 2, Stocchetti N. 3, Chieregato A. 4, Serioli T. 3, Zuccoli P. 3, Parma A. 5, Trazzi R. 5

From the Department of Anaesthesia and Intensive Care
1 University of Genova
2 University of Padova
3 Ospedali Riuniti, Parma
4 Ospedale Bufalini, Cesena
5 University of Milan


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Background. The 2% for­mu­la­tion of the intra­ve­nous anaesthet­ic ­agent, pro­pof­ol (Dipri-van™), deliv­ers ­half the ­amount of lip­id com­pared ­with the orig­i­nal 1% for­mu­la­tion. This may pro­vide an accept­able alter­na­tive for ­patients who ­have an ­impaired abil­ity to metab­o­lise lip­ids.
Methods. This ­study was a mul­ti­cen­tre, ran­dom­ised, ­open com­par­i­son of par­allel ­groups. Seventy-­three ­adult ­patients under­go­ing elec­tive cran­i­ot­o­my in neu­ro­sur­gery ­were ran­dom­ised to ­receive ­either pro­pof­ol 1% (10 mg/ml) or pro­pof­ol 2% (20 mg/ml) for induc­tion and main­te­nance of anaesthe­sia.
Results. Analysis of induc­tion ­time (199 s, 1%; 202 s, 2%; p>0.05) and induc­tion ­dose (1.13 mg/kg, 1.12 mg/kg; p>0.05) ­shows ­that pro­pof­ol 1% and pro­pof­ol 2% are phar­ma­cod­y­nam­i­cal­ly equiv­a­lent. Both for­mu­la­tions ­were sim­i­lar regard­ing over­all admin­is­tra­tion ­rates, recov­ery ­times, hae­mod­y­nam­ic var­i­ables and tol­er­abil­ity. Plasma tri­gly­ce­ride lev­els, ­were low­er in the pro­pof­ol 2% ­group com­pared ­with the pro­pof­ol 1% ­group, and sig­nif­i­cant­ly low­er (p<0.05) ­from 1 to 4 ­hours ­after induc­tion.
Conclusions. We con­clude ­that pro­pof­ol 2% is as effec­tive and as ­well-tol­er­at­ed as pro­pof­ol 1% for anaesthe­sia and is an accept­able alter­na­tive to pro­pof­ol 1% in ­patients under­go­ing elec­tive cran­i­ot­o­my in neu­ro­sur­gery. The low­er lip­id ­load sug­gests it may be of par­tic­u­lar ben­e­fit to ­patients ­with dis­or­ders of lip­id metab­olism.

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