Purpose: This study compared propofol with methohexital for use in outpatient general anesthesia for oral surgery procedures.
Patients and methods: Fifty American Society of Anesthesia (ASA) class I or II patients undergoing elective minor oral surgery procedures were selected for inclusion in the study. Participants were randomly divided into two groups-propofol-treated and methohexital-treated. All anesthetic agents were titrated in bolus using dosages standardized by weight. After premedication with intravenous midazolam and fentanyl, general anesthesia was induced either by propofol or methohexital. The quality of the anesthesia was subjectively evaluated by the anesthetist, surgeon, and the patient. Also, a standardized battery of tests was developed to quantitatively evaluate recovery from anesthesia.
Results: Propofol showed significantly less percentage increase in diastolic blood pressure and heart rate than methohexital. However, at the same time, propofol showed significantly greater percentage lowering of diastolic blood pressure. The mean low heart rate percentage of preoperative baseline were different, but both were greater than 100%. The anesthetist and patient evaluations showed no statistically significant difference in the acceptance of either agent. No patient in either group had any recollection of pain with induction or any recollection of the operation itself. There were no statistically significant effects of group in recovery test performance, although patients tended to recover more quickly in the symbol digit test and object recall test with propofol. No patient complained of any postoperative complications secondary to the anesthetic.
Conclusions: Propofol is a suitable agent for induction and maintenance of general anesthesia for outpatient oral surgery procedures. It provides a smooth induction of anesthesia with few excitatory effects.