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Case Report
commonly performed in adult patients. A popular method
of providing anesthesia for LMA insertion is with the use
of intravenous propofol, which has the advantages of
inducing anesthesia rapidly and depressing upper airway
reflexes.
Despite the understanding of propofol’s molecular
actions, it is not clear how these effects at molecular
targets affect single neurons and larger-scale neural circuits
to produce unconsciousness. Scientists had found that the
onset of slow oscillation is a neural correlate of propofol-
induced loss of consciousness, marking as shift to cortical
dynamics in which local neuronal networks remain intact
but become functionally isolated in time and space. ［2］
Removal of an endotracheal tube in the presence of
minimal levels of residual block can potentially contribute
to pulmonary outcomes. Even though there is no adverse
hypoxemia has been described, the main complain
of this patient was dyspnea. Complete recovery from
neuromuscular blockade is rarely present at the time of
tracheal extubation. ［3］ According to the requirement
of the surgery, we finished our procedure without
neuromuscular block.
Together with the advancement in surgical techniques
has been the availability of better drugs with short
onset and duration of effect, resulting in quick recovery
from general anesthesia with smile. The advantages
of intravenous anesthesia using propofol over inhaled
Laboratory and Clinical CInavseestRigeaptoiortn
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anesthesia have been intensively discussed as the subject
of numerous studies with different results. The manner
in which the anesthetic drugs are delivered, including the
use of concomitant medication, may therefore influence
the optimal choice of anesthetic used to achieve early
recovery, and an understanding of the risks and benefits of
the anesthetic could assist the practitioner to determine
which anesthetic to use in clinical practice.
References
1 Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher
LA. Comparison of recovery profile after ambulatory anesthesia
with propofol, isoflurane, sevoflurane and desflurane:
a systematic review. Anesth Analg. 2004;98(3):632-641, table of
contents.
2 Lewis LD, Weiner VS, Mukamel EA, et al. Rapid fragmentation of
neuronal networks at the onset of propofol-induced
unconsciousness. Proc Natl Acad Sci U S A. 2012;109(49):
E3377-3386.
3 Murphy GS, Szokol JW, Marymont JH, Franklin M, Avram MJ,
Vender JS. Residual paralysis at the time of tracheal extubation.
Anesth Analg. 2005;100(6):1840-1845.
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