[Comparative study between anesthesia by continuous perfusion with propofol or thiopental-isoflurane in laryngeal surgery].

OBJECTIVE

To compare two anesthetic protocols for maintenance of anesthesia during laryngectomy (propofol vs thiopental-isoflurane), assessing its effects on intraoperative hemodynamic stability and recovery time after withdrawal of anesthesia.

PATIENTS AND METHOD

Thirty-one patients undergoing laryngectomy. Anesthetic technique was the same except for the maintenance anesthetic used (isoflurane in group I [n = 16]; propofol in group P [n = 15]). We recorded heart rate and systolic/diastolic arterial pressure before surgery, 10 minutes after induction, at 10, 60 and 120 min after start of surgery and at the end of the procedure. Postanesthesia recovery time was measured by the Steward test (recovery of consciousness, control of voluntary movement and of breathing) applied at 3, 5, 10, 30 and 60 min after withdrawal of anesthesia.

RESULTS

There were no demographic differences between the two groups and heart rate and systolic/diastolic pressures were comparable. Postanesthetic recovery time was shorter in group P than in group I, with a statistically significant difference 5 min after withdrawal of drug (p < 0.05) owing to the item recovery of consciousness in the Steward test (p < 0.05 at times 5 and 10 min for this item). There were no significant differences in control of breathing or movement.

CONCLUSIONS

Propofol for anesthetic maintenance is effective and safe. There are no differences in hemodynamic changes produced by propofol and isoflurane. Time until recovery of consciousness is longer with isoflurane, although we believe that this is not clinically relevant in this type of procedure.