DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162801

Evaluation of efficacy of priming dose of propofol in reducing induction dose requirements in patients undergoing elective surgeries under general anaesthesia

Devendra W. Thakare, Urvi H. Desai, Kailash S. Sharma

Abstract


Background: Priming principle refers to administration of a subanaestheic dose of an agent prior to its actual anaesthetic dose. Propofol is an effective substitute to thiopentone for intravenous induction. The objectives of the study were to evaluate whether priming with propofol would reduce induction of dose, reduce the peri-intubation haemodynamic changes, influence the severity of side effects and influence recall phenomenon.

Methods: Sixty patients of ASA Grade 1 and 2, between 18-55 years of age group, of both sexes, were selected on the basis of eligibility criteria and scheduled for elective surgery under general anaesthesia were divided into study and control groups of 30 patients each. The total dose of propofol including the priming (25% of total) dose of propofol, heart rate and blood pressure, baseline (before induction), immediately after intubation, 1 min, 3 min, 5 min after induction, SPO2 (% of oxygen saturation), recall phenomenon and other side effects post operatively were studied.

Results: The demographic data were comparable for age, weight and sex in both the groups. Total patients were divided into two groups with 30 patients each. It was observed that total induction dose of propofol was significantly decreased in the study group 72.33±9.53mg compared to control group 115.83±9.00mg. Heart rate was better maintained in study group with minimal post-intubation response. The values of systolic, diastolic and mean blood pressure observed at 1 min after induction also showed significant decrease in control group compared to study group.

Conclusions: Propofol produces smooth, rapid, pleasant and safe induction. Priming with propofol can be practiced due to its cost effectiveness and better haemodynamic profile and safety.


Keywords


Propofol, Priming principle, Peri-intubation, General anaesthesia

Full Text:

PDF

References


Rajkumar G, Thokchom R, Pradhan PC, Singh MKH, Singh HT, Singh RN. Co-induction effects of midazolam, thiopentone and ketamine with propofol in general anesthesia. J Med Soc. 2013;27(2):110-3.

Karlo R, Singh NR, Singh KM, Singh TH, Devi NA, Devi MB. Priming effects of propofol during induction of anesthesia. J Med Soc. 2015;29(2):92-5.

Shashank DS, Singh NR, Singh LK. Effects of pretreatment with different neuromuscular blocking agents on facilitation of intubation with rocuronium: A prospective randomized comparative study. IJA. 2014;58(3):303-8.

Khan KS, Hayes I, Buggy DJ. Pharmacology of anaesthetic agents I: intravenous anaesthetic agents. Contin Educ Anaesth Crit Care Pain. 2013. doi: 10.1093/bjaceaccp/mkt039.

Doze VA, Shafer A et al. Propofol- Nitrous Oxide versus thiopentone-isoflurane- nitrous Oxide foe general anaesthesia. Anaesthesiology. 1988;69:63-71.

Edelist G. A Comparision of thiopentone and propofol as induction agents in outpatients surgery. Can J Anaesth.1987;34(2):110-6.

Claeys M. A. Gepts E, Camu F. Haemodynamic changes during Anaesthesia induced and maintained with propofol . Br.J.Anaesth 1998;60(1):3-9.

Bassil A et al. Propofol versus Thiopentone for induction of Anaesthesia in patients undergoing out patient surgery. Middle East J. Anaesthesia 1989;10:307-14.

Scheepstra GL, Booij LH, et al. Propofol for induction and maintenance of anesthesia: comparision between younger and older patients. Br J Anaesth. 1989;62:54-60.

Briggs L.P. White M. The effects of premedication of anaesthesia with propofol. Post grad. Med J 1985;61 (Suppl 3) 35-47.

Tighe KE, Warner JA. The effect of co-induction with midazolam upon recovery from propofol infusion of anaesthesia. Anaesthesia. 1997;52:998-1014.

Peacock JE, Lewis RP, et al. Effect of different rates of infusion of propofol for induction of anaesthesia in elderly patients. Br J Anaesth. 1990;65:346-352.

Maroof M, Khan RM, Bhatti TH. Priming Principle and induction dose of propofol. Anaesth Analg. 1996;82:S1 – S15.

Singletone JD. Induction pain perception after Premedication with propofol vs lignocaine: a pilot study. AANA J. 2000;68(2):149-51.