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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The induction characteristics, dosage requirements, cardiovascular and respiratory effects of propofol with added lignocaine were compared with those of thiopentone and halothane inhalational induction in two groups of children aged 1-5 years and 5-10 years. Propofol induction produced significantly greater decreases in blood pressure, particularly in the 1-5 year age group. Heart rate was maintained well with all three induction techniques. Pain on injection into a vein on the dorsum of the hand was significantly more common with propofol despite the addition of lignocaine. However, this was mild in the majority of children and did not interfere with the induction of anaesthesia. The incidence of respiratory depression and other adverse effects was low with all three induction methods. The mean induction doses of both intravenous agents were greater in the 1-5-year age group. The ratio of thiopentone to propofol dose was approximately 2.5:1 in both age groups. The high incidence of pain on injection with propofol may prove to be a significant drawback to its otherwise satisfactory use in children.
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PMID:Propofol for induction of anaesthesia in children. A comparison with thiopentone and halothane inhalational induction. 326 Nov 39

Propofol is an intravenous anesthetic currently available for clinical investigative use. The intraoperative and postoperative effects of propofol were compared to methohexital when used as an adjuvant to nitrous oxide for outpatient anesthesia. Sixty healthy young women were randomly assigned to receive either methohexital, 1.5 mg/kg intravenously (IV), or propofol, 2.5 mg/kg IV, for induction of anesthesia. Both drugs produced transient cardiovascular and respiratory depression after induction. Maintenance of anesthesia consisted of either methohexital, 6 +/- 2 mg/min, or propofol, 7 +/- 2 mg/min (mean +/- SD) by continuous infusion in combination with nitrous oxide, 70% in oxygen. Use of a propofol infusion was associated with lower blood pressures and heart rates during maintenance. Propofol was associated with fewer side effects (e.g., hiccoughing, nausea, and vomiting) intra- and postoperatively. Recovery times for awakening, orientation, and ambulation were consistently shorter with propofol. We conclude that propofol is a useful alternative to methohexital for induction and maintenance of outpatient anesthesia.
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PMID:Comparison of propofol with methohexital for outpatient anesthesia. 349 Jan 95

The induction and recovery characteristics of equivalent doses of propofol and methohexitone were compared in 50 patients undergoing day case isoflurane anaesthesia. Propofol induction was smoother but was associated with greater cardiorespiratory depression. Both the speed and quality of recovery were superior with propofol compared with methohexitone.
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PMID:A comparison of propofol and methohexitone as induction agents for day case isoflurane anaesthesia. 349 24

The new emulsion formulation of di-isopropyl phenol (propofol) was compared with methohexitone and thiopentone for induction of anaesthesia in day cases. Propofol produced significantly smoother induction of anaesthesia, but caused more cardiovascular and respiratory depression. Pain on injection was significantly less than with methohexitone. Post-anaesthetic recovery was superior with propofol, with virtual absence of side effects, and rapid recovery with little impairment of psychomotor function 30 min after anaesthesia.
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PMID:Comparison of the new emulsion formulation of propofol with methohexitone and thiopentone for induction of anaesthesia in day cases. 387 40

Propofol was compared with methohexitone for provision of light general anaesthesia in patients undergoing surgery under spinal analgesia. Intermittent bolus administration of both agents proved a feasible way of maintaining anaesthesia, a mean infusion rate of 0.13 mg kg-1 min-1 being required for propofol and 0.089 mg kg-1 min-1 for methohexitone. Propofol produced smoother anaesthesia with significantly fewer excitatory side effects and less pain on injection, but cardiovascular and respiratory depression occurred commonly. Recovery was rapid with both agents, but minor postoperative sequelae occurred more frequently after methohexitone.
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PMID:Comparison of propofol with methohexitone in the provision of anaesthesia for surgery under regional blockade. 387 17

We studied EEG arousal after laryngoscopy and intubation with standardized bolus induction of anaesthesia. Twenty patients were prospectively allocated randomly to induction with propofol 3 mg kg-1 (n = 10) or thiopentone (6 mg kg-1 (n = 10) and 50% nitrous oxide in oxygen. Neuromuscular block was produced with vecuronium 0.2 mg kg-1 given 30 s after induction. Three minutes after induction, laryngoscopy was performed for 60 s, with intubation at 3 min 30 s, and study end at 5 min. Nociception to laryngoscopy and intubation was followed by loss of low (relative delta activity change: thiopentone -30%, propofol -7%; P < 0.05) and a shift to higher frequency EEG activity (beta activity change: thiopentone +647%, propofol +61%; P < 0.05). This EEG arousal was greater in the thiopentone group, despite the fact that EEG depression was similar to that produced by propofol before laryngoscopy and intubation. Propofol and thiopentone in combination with nitrous oxide had similar cortical depressant effects, but propofol appeared to depress subcortical nociceptive processing more than thiopentone. While the degree of cortical EEG depression seems less useful for predicting reaction to subsequent nociception, EEG arousal reactions may prove suitable for monitoring intra-anaesthetic nociception and its modulation.
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PMID:EEG arousal during laryngoscopy and intubation: comparison of thiopentone or propofol supplemented with nitrous oxide. 878 60

Patients in the ICU who require intubation and mechanical ventilation benefit from adequate sedation and analgesia. Traditionally, this has been achieved using benzodiazepines and opioids. Alternatively, propofol is being administered for sedation of patients in the ICU with increasing frequency. Propofol has a number of properties that make it a potentially superior choice for sedation of intubated ICU patients. The rapid onset and offset of sedation with propofol, even after prolonged administration, allow for greater control over the level of sedation and more rapid weaning from mechanical ventilation. In addition, long-term administration of propofol does not appear to be associated with the development of tolerance, addiction, or withdrawal following discontinuation. Propofol suppresses cellular oxygen consumption and carbon dioxide production without increasing anaerobic metabolism. This may be beneficial in patients with severe hypoxemia, hypercarbia, or myocardial ischemia. Finally, the use of propofol may reduce or eliminate the need for other medications in these patients such as muscle relaxants, antihypertensives, lipid nutritional supplements, and analgesics, thereby simplifying their medication regimens and reducing the overall cost of their care while in the ICU. Propofol can be administered to critically ill patients for sedation with a high degree of safety and efficacy. Propofol causes systemic vasodilatation which may result in unwanted hypotension, especially in patients who are already hemodynamically compromised. Propofol also causes ventilatory depression, so its use should be restricted in the ICU to patients whose airway is protected by an endotracheal tube and whose ventilation is closely monitored. Finally, continuous administration of propofol may cause clinically significant hypertriglyceridemia in patients with disordered triglyceride metabolism, or in patients receiving excessive doses of propofol or parenteral lipid supplements. Although propofol is more expensive than equipotent doses of other sedative agents, the additional cost of using propofol for sedation of critically ill patients in the ICU may be more than offset by the savings accrued from faster times to extubation, shorter ICU stays, and the use of fewer medications to manage these patients. Further research needs to be done to determine the potential clinical and cost benefits of using propofol for sedation of patients in the ICU.
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PMID:Propofol: a new drug for sedation in the intensive care unit. 763 54

Propofol is commercially available as Disoprivan. It is formulated as an aqueous emulsion with 1% 2,6-diisopropylphenol, 10% soya bean oil, 2,5% glycerol and 1.2% egg phosphatide. Since 1986, propofol has been used as a sedative drug in the ICU and is highly valued for its numerous positive qualities. High effectiveness is combined with excellent control, which is demonstrably still present even after 2 weeks of sedation. This control enables short-term neurological surveillance of the patient and rapid weaning from the respirator once drug administration is stopped. Propofol does not disturb cerebral autoregulation. Depression of spontaneous breathing facilitates the ventilation of intubated patients. As the solution contains lipids, it contributes to parenteral nutrition. All in all, ease of control and rapid response make propofol a highly valued product in ICUs. It is easy to understand why many ICU specialists consider propofol an ideal drug for long-term sedation. The present authors, however, are convinced that certain limitations must be taken into account. First, cardiovascular depression, especially if potentiated by drugs such as beta- and Ca-entry blockers, may lead to hypotensive episodes. Potential problems (drug tolerance, hypertriglyceridaemia) may be revealed in long-term studies. As long as no such studies have been presented, the authors believe that it is too early to consider propofol the ideal drug for long-term sedation.
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PMID:[Propofol: the ideal long-term sedative?]. 776 77

Propofol is a greater cardiovascular depressant agent than barbiturates (thiopentone, methohexitone). It is agreed that propofol changes the ventricular load as a result of its vasodilating effects, and that it depresses the sympathetic nervous system and the baroreflex, which result in a moderate bradycardia. The direct effects of propofol on the myocardium remain controversial. Propofol has no significant direct effect on intrinsic myocardial contractility and the decrease in cardiac output is related to anaesthesia on the one hand and to changes in ventricular load and the activity of the cardiac autonomic nervous system on the other hand. It is therefore understandable that the overall depressant effect of the cardiovascular system is amplified in patients whose ventricular function is closely dependent upon ventricular load and/or the activity of the sympathetic nervous system, and that the association with drugs causing bradycardia must be avoided. The logical therapeutic solution to propofol related cardiovascular depression, when deemed necessary, consists of vascular fluid loading and/or the administration of a vasoconstrictor.
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PMID:[Cardiovascular effects of Diprivan]. 787 44

Propofol has been used for the induction and maintenance of general anesthesia during pregnancy although this is not an indication approved by Zeneca Pharmaceuticals. Compared with thiopentone, propofol reduces the cardiovascular response to laryngoscopy and tracheal intubation. Maternal recovery from anesthesia may be marginally quicker. Neonatal outcome is satisfactory although one group of researchers has consistently preferred thiopentone to propofol. Compared with inhalational agents, infusions of propofol do not offer any significant advantages for the maintenance of anesthesia and the risk of neonatal depression is potentially greater. Although propofol has no major advantages to justify it replacing thiopentone for the induction of anesthesia in pregnancy, propofol does give satisfactory results and should be available as an alternative.
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PMID:Propofol during pregnancy. 803 74


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