Durée de l'anesthésie et mode d'administration du Diprivan ®

Abstract

The dosage regimen to maintain propofol anaesthesia should ensure adequate depth of anaesthesia for the procedure, and allow a swift recovery. If the dosage is not adapted to the various phases of surgery, there is a risk of awareness especially after painful stimuli. This awareness is not always announced by signs which would allow its prevention. It is characterized by patient's movements but does not result in a memorization of the episode, except if the patient opens his eyes at that moment. Conversely, if propofol blood concentration is maintained at a sufficiently high level to prevent such unexpected movements, it will be necessary to reduce this concentration in the last stage of surgery to avoid a delayed recovery. Intermittent bolus injections and not controlled infusions are gradually abandoned. The optimal use of propofol should rely on the: 1. Use of an infusion pump (volumetric pump) which ensures regular administration: 2. Correct choice of administration technique, that ensures the most stable anaesthesia regardless of the type of operation, using the least possible amount of anaesthetic agent; 3. Combination of points 1 and 2, the first intellectual step towards progressively acquainting anaesthetists with the simultaneous use of an automated administration associated with a computer, which is the most reliable and effective technique today.