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British Journal of Anaesthesia, 2001, Vol. 87, No. 2 283-286
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

Loss of volition and pain response during induction of anaesthesia with propofol or sevoflurane

S. Thompson and G. B. Drummond

Department of Anaesthetics, Royal Infirmary, Edinburgh EH3 9YW, UK*Corresponding author

We compared the time to reach two anaesthetic end-points during induction of anaesthesia with a potent inhalation agent (sevoflurane) and an i.v. agent (propofol). We used a method to ensure steady breathing during inhalation induction, and measured loss of tone in the outstretched arm and loss of response to a painful stimulus. Thirty-eight female patients (age 39 (9) yr, weight 65 (11) kg, and height 165 (8) cm) (mean (SD)) were randomly allocated to receive either propofol or sevoflurane. The predicted induction dose of propofol, estimated from age and weight for each patient, was given at a rate of 1% of the induction dose per second, to a possible maximum of 2.5 times the predicted induction dose. Sevoflurane was given with an inhaled concentration of 8%, which was anticipated to cause loss of arm tone within 90–120 s. After loss of consciousness, we applied a painful electrical stimulus to a finger at 15-s intervals and measured the time to loss of motor response. The median times and interquartile values for loss of arm tone were 105 (88–121) s for sevoflurane and 65 (58–80) s for propofol. This was equivalent to 0.65 of the ED50 of propofol. The time to loss of response to pain was 226 (169–300) s for sevoflurane. The variances of these three measurements were not significantly different, indicating that these dose–response relationships were similar. In contrast, only 11 of the patients given propofol lost the response to pain after 2.5xED50 had been given. These results support previous evidence of substantial differences between anaesthetic end-points, and show that this evidence can be obtained using a simple and rapid method.

Br J Anaesth 2001; 87: 283–6


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C. L. Knaggs and G. B. Drummond
Randomized comparison of three methods of induction of anaesthesia with sevoflurane
Br. J. Anaesth., August 1, 2005; 95(2): 178 - 182.
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