Wakabayashi, Koji2024-11-122024-11-122023Wakabayashi, Koji. (2023). Low dose propofol as an effective method in attenuating the cardiorespiratory response to extubation: single-blinded randomised placebo- controlled trial [Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.https://hdl.handle.net/10539/42365A research report submitted in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Anaesthesiology to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2023Background Extubation at the end of general anaesthesia should be performed in a way that ensures patient comfort and minimizes cardiorespiratory changes to prevent harm. Several drugs have been shown to attenuate these changes during emergence. The aim of our study was to investigate if a sub-hypnotic dose of propofol is able to produce such favourable peri- extubation conditions. Methods Fifty ASA grade I-II patients (aged 18-70) undergoing elective abdominal or pelvic surgery under general anaesthesia with a volatile agent were randomly assigned to a propofol group (P=28) or a control group (C=22). At the end of surgery, once the minimal alveolar concentration reached 0.6, patients received either propofol 0.5 mg kg-1 or an equivalent volume of isotonic saline intravenously. The primary outcome was the incidence and severity of bucking and coughing observed during emergence, with the assessment performed by a blinded anaesthetist. Haemodynamic parameters, airway responses, extubation complications and time to extubation were evaluated during the emergence period at predetermined intervals. Results The demographic and clinical characteristics of the two groups were comparable prior to surgery. Results indicated the incidence and severity of bucking at extubation was significantly lower (21.4%) in the propofol group compared to the control group (68.2%) (p<0.001). Similarly, patients in the propofol group had significantly fewer heart rate (p=0.031) and systolic blood pressure changes at extubation (p=0.031). Conclusion The addition of propofol 0.5 mg kg-1 prior to extubation successfully attenuated cardiorespiratory responses following general anaesthesia in ASA I-II adult patients undergoing elective abdominal or pelvic surgery, but did not reduce the overall incidence of cough at extubationen© 2023 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.Low dose propofolCardiorespiratoryUCTDSDG-3: Good health and well-beingDissertationUniversity of the Witwatersrand, Johannesburg