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Propofol-based Fast-track for Ambulatory Surgery


Siriwan Jirasiritham MD*,
Kamthorn Tantivitayatan MD*, Sopon Jirasiritham MD**
* Department of Anesthesiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University
** Department of Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University


The purpose of this study was to provide data of propofol-based total intravenous anesthesia (TIVA)
for ambulatory surgery in developing a fast-track technique. One hundred and forty-two patients scheduled
for elective surgery were studied : mean (SD) age 42.21(16.23) years, male to female 72 : 70, mean (SD) body
weight 60.75 (11.67) kg and American Society of Anesthesiologists (ASA) physical status I / II/ III 66/38/38.
Mean (SD) thiopental induction 225 (55.69) mg was maintained with mean (SD) propofol 199.64 (86.26)
mg for mean (SD) anesthetic time 29.02 (11.21) minutes. Various narcotics were used : fentanyl 73.48 +
24.38 µg for 123 cases, morphine 3.27 + 1.10 mg for 10 cases, remifentanil 492 + 105.26 µg for 7 cases and
pethidine 23.33 + 2.88 mg for 2 cases. Midazolam was given 2.70 + 1.05 mg. Patients were positioned in
supine, lithotomy or lateral decubitus. One-fourth were PS III with a diagnosis of chronic renal failure and
renal transplants coming for incision and drainage of perianal abscess. The mean (SD) wake-up time was
36.02 (17.69) seconds. Only one case (chronic renal failure) had severe hypotension after induction.
Anesthetic agents and ideas of fast-track anesthesia were discussed.

Keyword : Propofol, Fast-track, Ambulatory, Total intravenous anesthesia, TIVA

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