Effect of propofol titration and traditional administration on hemodynamic changes during general anesthesia induction

AIM: To compare the hemodynamic changes of the patients with propofol induction by titrated administration and traditional administration. METHODS: Sixty patients with American Society of Anesthesiology (ASA) I or II, aged 18~60 years and scheduled for elective surgery under general anesthesia, were selected in the study and randomly divided into 2 groups. The patients in group I received intravenous infusion of propofol at the dose of 2 mg/kg by a Fresenius pump at the rate of 250 mg·min-1. The patients in group II received intravenous infusion of propofol by a Fresenius pump at the rate of 1 mg·kg-1·min-1 until the OAA/S scale of the patients reached 1, then propofol administration changed to a maintenance dose (1 mg·kg^-1·h^-1 ). As propofol was administered, fentanyl (4 μg·kg^-1) was intravenously pumped (250 μg·min^-1) at the same time. Cis-atracrium (2 mg·kg^-1) was intravenously given 1 min after completion of propofol in group I, and after the patients fell asleep in group II. Tracheal intubation was performed 4 min later. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR) and pulse oxygen saturation (SpO₂) were monitored at different time points during induction period. The cases of the patients whose blood pressure decreased by more than 30% were recorded. The patients were asked whether they could recall the intubation process next day after operation. RESULTS: All patients were successfully intubated at the first attempt and no recall of the intubation process was observed. The decreases in SBP and MBP 1 and 3 min after propofol administration and DBP 1 min after propofol administration in group II were significantly less than those in group Ⅰ(P<0.01). The cases of blood pressure decreasing by more than 30% in group II were also less that those in group I. CONCLUSION: Titration of propofol for anesthesia induction not only provides satisfying anesthesia for intubation, but also offers more stable hemodynamics.