Comparaison propofol-méthohexital en chirurgie stomatologique et maxillo-faciale

Abstract

A prospective study has been undertaken to compare a new intravenous anaesthetic agent, propofol, to methohexitone in 40 ASA I or II patients aged between 18 and 50 years undergoing maxillo-facial surgery and divided into two groups. Intramuscular premedication was standardized for all patients. In group I, propofol 2 mg · kg −1 was injected over 1 min in a peripheral venous line with fentanyl 0.86 μg · kg −1, followed by an infusion of propofol 5 mg · kg −1 · h −1 and fentanyl 3 μg · kg −1 · h −1. In group II, the fentanyl dosage was the same as in group I, whilst methohexitone 3 mg · kg −1 was given for induction and 4.5 mg · kg −1 · h −1 for maintenance of anaesthesia. The following were recorded during induction, maintenance and recovery; haemodynamic parameters using a non invasive method; respiratory parameters; quality of anaesthesia; side-effects. Statistical analysis was performed using the Student t test and qualitative analysis using the Schwartz comparison test at 2%. The following results were found : the quality of anaesthesia with propofol was superior to that of methohexitone during the three stages of anaesthesia. The duration of induction was similar in both groups, but the quality of induction (occurrence of more minor side-effects; p <0.05) and intubation was in favour of propofol (p <0.05). During maintenance, stability of anaesthesia and a lesser incidence of side-effects were again in favour of the propofol group, in which a slower rate was also found (p <0.001). However, it was during recovery that propofol appeared even more beneficial. Recovery was faster for all the parameters studied (p <0.001). The recovery time for integration functions was more than twice as long in the methohexitone group (65 min) as in the propofol group (30 min).