J Dent Anesth Pain Med.  2018 Jun;18(3):169-175. 10.17245/jdapm.2018.18.3.169.

Comparative randomized study of propofol target-controlled infusion versus sevoflurane anesthesia for third molar extraction

• Chung PK
• Dhanrajani P

• KMID: 2415181
• DOI: http://doi.org/10.17245/jdapm.2018.18.3.169

Abstract

BACKGROUND
The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth.
METHODS
One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group.
RESULTS
Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065).
CONCLUSION
Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

Keyword

Propofol; Sevoflurane; Target-Controlled Infusion

MeSH Terms

Anesthesia*
Anesthesia, General
Anesthesia, Intravenous
Arterial Pressure
Bradycardia
Comorbidity
Heart Rate
Hemodynamics
Humans
Intubation
Molar, Third*
Nausea
Propofol*
Reflex
Tooth
Vomiting
Propofol

Figure

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  Fig. 1 Box-and-whisker plot comparing the heart rates between the two anesthetic groups.

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  Fig. 2 Box-and-whisker plot comparing the heart rates from anesthetic induction to intubation and from anesthetic injection to induction.

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  Fig. 3 Box-and-whisker plot comparing the mean arterial pressure between the two anesthetic groups

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  Fig. 4 Box-and-whisker plot comparing the mean arterial pressure from induction to intubation and from injection to induction.

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