Anesthesia with alfentanil and methohexitone for short gynecological surgery. A comparison with thiopentone/nitrous oxide.

An anesthetic technique in which alfentanil hydrochloride, an ultra-short-acting opioid, was used as a substitute for N2O/O2 was evaluated in outpatient gynecological surgery. Methohexitone was used as a hypnotic agent. The following parameters were studied: blood pressure (BP) and heart rate before, during and at the end of surgery; the incidence of apnea longer than 20 s at induction; the awakening phase; immediate postoperative complications and later postoperative complications according to a questionnaire, including signs of thrombophlebitis. Eighty-nine patients were randomly allocated to three groups. Twenty-nine patients received alfentanil 7 micrograms/kg plus methohexitone plus O2/air (Group A7). Thirty patients received alfentanil 15 micrograms/kg plus methohexitone plus O2/air (Group A15). Thirty patients received thiopentone 5 mg/kg plus N2O/O2 (Group P, reference group). Neither in the A7-group, nor in the A15-group was there any increase in peroperative BP, while in the P-group both systolic and diastolic BP rose. The awakening phase was significantly shorter in both the A7- and A15-groups compared to the P-group. Apnea of clinical importance was only seen in the A15-group. There were few immediate postoperative complications in all groups, but the incidence of dizziness was significantly higher in the P-group. According to the questionnaire, the overall incidence of complaints the day after surgery was somewhat higher in the P-group. On the other hand, there was a somewhat higher incidence of thrombophlebitis in both A-groups. We may thus recommend the use of a combination of alfentanil 7 micrograms/kg plus methohexitone and air/oxygen for anesthesia in patients subjected to short gynecological procedures.