Background : During Thoracoscopic sympathectomy hypotension occurs frequently. In this study we compared propofol with etomidate as a main anesthetic agent for thoracoscopic sympathectomy by observing intraoperative vital signs, postoperative
recovery
and side effects.
Methods : Thirty adult patients scheduled for both thoracoscopic sympathectomy were allocated to groups P (propofol) or E (etomidate). P-deletion test (PDT) was dome and plasma cortisol level was measured. In group P (n = 16), anesthesia was
induced
with fentanyl 100 μg, propofol target controlled infusion (TCI) and vecuronium. Anesthesia was maintained with N2O (60%)-propofol. MAP, HR and bispectral index were measure before induction, right after positioning, at the beginning of
right
and left sympathectomy. In group E(n = 14), anesthesia was induced and maintained with etomidate instead of propofol. Postoperative recovery was assessed on the basis of modified Aldrete scoring system at 5, 15, 30, 60 minutes postoperatively. PDT
was
performed at 1, 2 hours postoperatively. Plasma cortisol level was measured 2 h and 3 days after operation. Occurrence of myoclonic movement and nausea was recorded.
Results : MAP was lover in group P (P < 0.05). There was no difference between groups in HR, plasma cortisol concentration. The values of BIS, PDT, recovery score of group P were higher than those of group E (P< 0.05). The incidence of nausea was significantly higher in group E (P < 0.05). Conclusions : Etomidate anesthesia provided more stable vital signs during thoracoscopic sympathectomy compared to propofol anesthesia. However, in terms of recovery and nausea, better outcome was suggested in propofol anesthesia.
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