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BJA Advance Access originally published online on June 17, 2006
British Journal of Anaesthesia 2006 97(2):154-159; doi:10.1093/bja/ael141
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Comparison of xenon with propofol for supplementary general anaesthesia for knee replacement: a randomized study

L.S. Rasmussen1,*, W. Schmehl2 and J. Jakobsson3

1 Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
2 Linde Gas Therapeutics Hamburg, Germany
3 The Karolinska Institutet Sabbatsberg Hospital Stockholm, Sweden

*Corresponding author: Department of Anaesthesia 4231, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark. E-mail: lsr{at}rh.dk

Background. Xenon anaesthesia is associated with rapid recovery and may also offer protection against neuronal damage. The aim of this study was to compare xenon with propofol for supplementary general anaesthesia in patients undergoing knee replacement in spinal anaesthesia.

Methods. In total, 39 patients aged 60 or over were randomized to xenon 50–70% or propofol 3–5 mg kg–1 h–1. Vital signs and emergence time were recorded and cognitive function was assessed before operation, at discharge between the third and the fifth day and at 3 months using four neuropsychological tests.

Results. Propofol supplementation was necessary in six xenon patients (29%) because of detectable movement of the upper body. Emergence time was significantly shorter with xenon (260 s for xenon and 590 s for propofol, P=0.001). There was no significant difference between the groups in blood pressure, heart rate, ventilatory frequency or end-tidal carbon dioxide concentration. No difference could be detected in cognitive function, which may be attributed to insufficient sample-size rather than the absence of a true difference.

Conclusions. Xenon was well tolerated for supplementary general anaesthesia in elderly spontaneously breathing patients but supplementation may be necessary. Compared with propofol, emergence was faster with xenon. A larger sample-size is needed if cognitive function is to be addressed.


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