Which intravenous induction agent for day surgery?

Abstract

SummaryEighij, d q patients for the vaginal termination of pregnancy were rundomly allocated to receive thiopentone, propofol, methohesironv or etomidate us intravenous induction agents. The same anaesthetist administered the anaesthesia and all the observers were hlind to the agents used. The results show that thiopentone and propofol produced the least sequelae at induction and in recovrrj'. Furthermore, both ugents produced a high quality cf induction and recovery. AN patients were discharged home 2 hours postoiperutivelj~ and there was no obvious delay in recovery. Thii study has altered clinical practice in our Day Surgery Unit.

Incidence of wound infection in orthopaedic same day surgery and its financial implication

“…Olderl2 reported the incidence of two cases among 2838 cases (the incidence of O.O7%) of same day orthopaedic surgery cases, one case after arthroscopic surgery, one case after osteotomy. Seeing the above figure, the incidence of postoperative wound infection in this series was relatively higher (2,9 %),but if we compare with the incidence of postoperative wound infection in orthopaedic in-patient surgery cases in this series, which was 6.9%, or with the incidence of postoperative wound infection in the same hospital but in another period of study, done by the author (which were 4S% and 5.57o),t3'la the incidence of postoperative wound infection in same day orthopaedic surgery was relatively and significantly lower. However realizing the fact that the comparison of the incidence between same day surgery procedure and in-patient surgical procedure was done using case series of different periods (the incidence of 6.9% in 1988 was before the policy of implementing same day surgery procedure and the incidence of 2.9% in 1989 was the incidence in the period after the implementation of the policy), and using different composition of cases (27.9% and 6.97o were the incidence among the patients in three hospitals, one government and two private hospitals, and 4.9% was the incidence among the patients in one government hospital, whereas 5.5% was the incidence among cases of private hospital), we have to be very careful in making the conclusion of this research.…”

General anaesthesia for thyroplasty

“…The use of propofol as the induction agent and sevoflurane for maintenance of anaesthesia allowed for rapid recovery from anaesthesia. Rapid early phase recovery after propofol is well documented in unpremedicated day‐case patients [6, 7] and also in more prolonged in‐patient procedures [8]. The low incidence of side‐effects following emergence, in particular nausea and vomiting [9], are especially advantageous for this surgery.…”