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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 418-422
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

ALFENTANIL AND PROPOFOL INFUSIONS FOR SURGERY IN THE BURNED PATIENT

C. J. REYNEKE, M.B., CH.B., D.A.(S.A.), F.F.A.(S.A.), M. F. M. JAMES, M.B., CH.B.(BIRM.), F.F.A.R.C.S. (ENG.)* and R. JOHNSON, M.B., CH.B.

Department of Anaesthesia, Hillbrow Hospital Johannesburg, S. Africa

*Present address for correspondence: Department of Anaesthesia, University of Cape Town, Medical School, 7925 Observatory, Cape, Republic of South Africa.

We have studied combinations of alfentanil and propofol for total i.v. anaesthesia in 24 severely burned patients. No inhalation agents were used. After a loading dose of alfentanil 100 µg kg–1, the intraoperative requirement was 1.24 (SEM 0.7) µg kg–1 min–1, and after a propofol induction dose of 2 mg kg–1 the maintenance rate was 100 µg kg–1 min–1. Initial hypotension occurred after induction of anaesthesia, but during the operation, cardiovascular variables were stable. After adequate antagonism of neuromuscular block, respiratory depression persisted in three patients when the two agents were discontinued simultaneously; this was not seen when alfentanil was discontinued 15 min before propofol. Quality of recovery was good, and satisfactory postoperative analgesia was present in the majority of patients 2 h after operation. This study indicates that total i.v. anaesthesia with a combination of alfentanil and propofol appears to be satisfactory in burned patients.


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