Propofol (2,6,di-isopropylphenol) was given by continuous intravenous infusion to provide sedation after cardiac surgery in 30 patients and its effects compared with those of midazolam given to a further 30 patients. Propofol infusion allowed rapid and accurate control of the level of sedation, which was satisfactory for longer than with midazolam. Patients given propofol recovered significantly more rapidly from their sedation once they had fulfilled the criteria for weaning from artificial ventilation and as a result spent a significantly shorter time attached to a ventilator. There were no serious complications in either group. Both medical and nursing staff considered the propofol infusion to be superior to midazolam in these patients. These findings suggest that propofol is a suitable replacement for etomidate and alphaxalone-alphadolone for sedating patients receiving intensive care.

The effects of trimetaphan camsylate and sodium nitroprusside on the catecholamine response to cardiac surgery were compared in a randomised double blind study of twelve male patients undergoing elective myocardial revascularisation. The solutions were titrated to maintain a mean arterial pressure of 70-85 mm Hg before and after bypass and less than 70 mm Hg during bypass. The rise in plasma adrenaline during cardiopulmonary bypass in the sodium nitroprusside group was significantly greater than that in the trimetaphan camsylate group. There was a smaller rise in plasma noradrenaline in the sodium nitroprusside patients but this was significantly higher than in the patients receiving trimetaphan camsylate. Administration of trimetaphan camsylate provides a simple and effective way to reduce catecholamine release during cardiopulmonary bypass.

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