Post-Operative Effects: Comparison of Total Intravenous and Inhalational Anesthesia (original) (raw)
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Scholars journal of applied medical sciences, 2020
Original Research Article Introduction: Propofol is a short-acting medication that results in a loss of consciousness and lack of memory for events. Sevoflurane is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anaesthetic for induction and maintenance of general anesthesia. We have a very few comparative data regarding these two anaesthetic agents. Aim of the study: The aim of this study was to compare the postoperative complications between "total intravenous anesthesia with propofol" and "sevoflurane inhalation anesthesia". Methods: This retrospective study was conducted in Pioneer Hospital, Chattogram, Bangladesh. During the period from January 2018 to December 2018. In total 94 patients who had ENT surgeries previously were finalized as the total study population. Total patients were divided into 2 groups. In Group I there were 43 patients to whom total intravenous anesthesia with propofol (TIVA) had been used and in Group II there were 51 patients to whom sevoflurane inhalation anesthesia (SIA) had been used. Postoperative complications and recovery period were determined as tachycardia, bradycardia, hypertension, hypotension, recovery time, additional analgesia and nausea-vomiting. Result: For the patients who had surgeries under TIVA, the additional analgesia and nausea-vomiting incidences were found as 23.26% and 20.93% respectively and the recovery period was 12 minutes. On the other hand, for the patients who had surgeries under SIA, the additional analgesia and nauseavomiting incidences were found as 19.61% and 33.33% respectively and the recovery period was 8 minutes. Conclusion: Due to retrospective nature of this study, results were depended on the records of patient's files only and it was a limitation of this study. According to the analysis of complications regarding two different procedures we found near about the similar performance. Although there was a difference between the lengths of recovery time but that doesn"t a big issue to differ among the procedures. As it was a single centered study with some unavoidable limitations, to get more specific information we would like to recommend for conducting more studies in several places.
OBJECTIVE: The aim of this study was to determine the effects of total intravenous anesthesia with propofol and fentanyl compared with those of isoflurane and fentanyl on recovery characteristics, postoperative nausea and vomiting (PONV) and duration of hospitalization. METHODS: Patients classified as ASA status I or II undergoing elective short surgical procedures, with duration up to one hour were enrolled in the study. Patients were randomly assigned at a 1:1 ratio to receive total intravenous anesthesia with propofol (1.5–2.0 mg/kg) and fentanyl (1.5 μg/kg) or isoflurane (0.8%–1.2%), nitrous oxide and fentanyl (1.5 μg/kg). Extubation time, recovery time, PONV, postoperative antiemetic requirement and duration of hospitalization were recorded. Results: 120 patients completed the study. Recovery time was significantly shorter in the propofol group (n = 60) compared with the isoflurane group (n = 60) (7.0 [0.77] vs 8.5 [0.66] min, respectively; P< 0.005). In the propofol group, significantly fewer patients had vomiting episodes compared with those in the isoflurane group (4 [6.7%] vs 32 [53.3%]; P< 0.005). The duration of hospitalization after surgery was significantly shorter in the propofol group than in the isoflurane group (22.60 [3.6]vs. 25.5 [4.1]hours; P = 0.0001). CONCLUSION: Total intravenous anesthesia with propofol and fentanyl was associated with a significantly reduced rate of PONV , shortened recovery time and duration of hospitalization, compared with isoflurane and fentanyl in these patients undergoing surgery up to one hour .
Medicine, 2018
Clinical studies have shown that total intravenous anesthesia (TIVA) with propofol is associated with better postoperative pain control compared with inhalational anesthesia, while other studies have not shown any benefit. The analgesic effect of TIVA with propofol in colorectal surgery has not been studied. The aim of this study is to evaluate the postoperative analgesic effects of TIVA with propofol versus inhalational sevoflurane in colorectal surgery.This is a retrospective case-control study. Records of patients undergoing colorectal surgery from 2014 to 2016 (36 months) were retrieved. Ninety-five patients who received TIVA with propofol were matched against 95 patients who received inhalational sevoflurane. Acute postoperative numerical rating scale (NRS) pain scores, postoperative morphine consumption, patient satisfaction, and side effects were compared and analyzed for differences between TIVA with propofol and sevoflurane.There were no significant differences in NRS pain ...
PloS one, 2016
Patients receiving total intravenous anesthesia (TIVA) with propofol have been shown to experience less postoperative pain. We evaluated the post-operative analgesic effects of propofol compared with sevoflurane maintenance of anesthesia in liver surgery. This study was registered at ClinicalTrials.gov (NCT02179437). In this retrospective study, records of patients who underwent liver surgery between 2010 and 2013 were reviewed. Ninety-five patients anesthetized with propofol TIVA were matched with 95 patients anesthetized with sevoflurane. Numeric pain rating scale (NRS) pain scores, postoperative morphine consumption, side effects and patients' satisfaction with pain relief were evaluated. The TIVA group reported lower NRS pain scores during coughing on postoperative days 1 and 2 but not 3 (p = 0.0127, p = 0.0472, p = 0.4556 respectively). They also consumed significantly less daily (p = 0.001 on day 1, p = 0.0231 on day 2, p = 0.0004 on day 3), accumulative (p = 0.001 on day ...
National Journal of Medical Research, 2017
Introduction: Anesthetic agents today have been designed and marketed to meet specific niche criteria for ambulatory anesthesia. Propofol, Sevoflurane, etc. have significantly increased the ability of the anesthesiologist to provide a successful ambulatory surgical experience for the patient. This study was aimed at assessing the effect of Propofol and Sevoflurane in preventing postoperative nausea, vomiting and pain after laproscopic surgery among the patients of ASA 1 and 2. Methodology: All patients having ASA 1 and ASA 2 physical status scheduled for laparoscopic surgery in the age group 20 to 70 years not having clinically significant cardiovascular, respiratory, hepatic, renal, neurologic, psychiatric or metabolic disease; non-pregnant; not having morbid obesity; not having history of alcohol and drug abuse and willing to give informed consent were included in the study. Patients were randomly divided into two groups, of which one were administered Propofol and two were administered Sevoflurane to maintain anesthesia. Results: There were total 60 patients scheduled for laparoscopic surgery. Out of these 60 patients, 30 were administered Propofol and 30 were administered Sevoflurane as maintenance drug. Maximum number of nausea and vomiting were with Sevoflurane. Total 13 (43.3%) patients were having 4 times Nausea/Vomiting in first four hours postoperatively. Among patients to whom Propofol was administered, 17 (56.7%) not experienced any spell of nausea/vomiting in first 4 hours. Remaining patients also experienced only one spell of nausea/vomiting. post operative mild pain is seen in both group of patient. But moderate to severe pain is seen in Sevoflurane group. Least pain is seen in Propofol group. This suggestive that analgesic property of Propofol is greater than Sevoflurane.
Anesthesiology, 2001
Background: To assess the incidence of postoperative nausea and vomiting after total intravenous anesthesia (TIVA) with propofol versus inhalational anesthesia with isoflurane-nitrous oxide, the authors performed a randomized trial in 2,010 unselected surgical patients in a Dutch academic institution. An economic evaluation was also performed. Methods: Elective inpatients (1,447) and outpatients (563) were randomly assigned to inhalational anesthesia with isoflurane-nitrous oxide or TIVA with propofol-air. Cumulative incidence of postoperative nausea and vomiting was recorded for 72 h by blinded observers. Cost data of anesthetics, antiemetics, disposables, and equipment were collected. Cost differences caused by duration of postanesthesia care unit stay and hospitalization were analyzed. Results: Total intravenous anesthesia reduced the absolute risk of postoperative nausea and vomiting up to 72 h by 15% among inpatients (from 61% to 46%, P < 0.001) and by 18% among outpatients (from 46% to 28%, P < 0.001). This effect was most pronounced in the early postoperative period. The cost of anesthesia was more than three times greater for propofol TIVA. Median duration of stay in the postanesthesia care unit was 135 min after isoflurane versus 115 min after TIVA for inpatients (P < 0.001) and 160 min after isoflurane versus 150 min after TIVA for outpatients (P ؍ 0.039). Duration of hospitalization was equal in both arms. Conclusion: Propofol TIVA results in a clinically relevant reduction of postoperative nausea and vomiting compared with isoflurane-nitrous oxide anesthesia (number needed to treat ؍ 6). Both anesthetic techniques were otherwise similar. Anesthesia costs were more than three times greater for propofol TIVA, without economic gains from shorter stay in the postanesthesia care unit.
British Journal of Anaesthesia, 2008
Background. Endoscopic sinus surgery (ESS) is often affected by intra-nasal bleeding, which can be influenced by various anaesthetics and preoperative conditions. This study compared the surgical condition and the amount of intra-nasal bleeding between patients given sevoflurane/remifentanil (SR) and propofol/remifentanil (PR) anaesthesia. Methods. ASA I or II patients undergoing ESS were randomly assigned to group SR (n¼20) or group PR (n¼20). The extent of the preoperative surgical lesion was classified as high (.12) and low Lund-Mackay (LM) (12) scores according to the computed tomography findings. The amount of intraoperative blood loss was calculated from the patients' haemoglobin (Hb) and the amount of blood in the suction canister. The surgeons rated the visibility of the surgical field on a numeric rating scale (NRS). Results. In the high-LM score patients, the median (1st/3rd quartiles) blood loss for the SR and PR groups was 135 (121/222) and 19 (8/71) ml h 21 , respectively (P,0.01), and the mean (SD) of NRS was 5.8 (2.3) and 2.3 (1.0), respectively (P,0.05). However, in patients with low-LM score, both blood loss and NRS scores were not different between groups SR and PR. Conclusions. In the high-LM score patients, PR anaesthesia results in less blood loss and a better surgical conditions for ESS than SR anaesthesia.
Anesthesiology and Pain Medicine, 2013
The Anesthesia planning is an important and determining factor in the amount of intraoperative hemorrhage, which can affect the rate of intraoperative and postoperative complications. Objectives: In this study we used two different anesthesia techniques in functional endoscopic sinus surgery (FESS) and compared the amount of hemorrhage in the two groups. Patients and Methods: In a single-blind clinical trial, 44 patients with ASA class I and II candidate for FESS in Amir-Al-Momenin hospital in Rasht were entered the study and divided into two equal groups randomly. In both groups anesthesia was induced with propofol, remifentanil and cis. atracurium and then, infusion of propofol -remifentanil in the first group and isoflurane plus Remifentanil infusion in the second group was used for maintenance of anesthesia. Systolic blood pressure was maintained about 90 mmHg. Then on the basis of maximum allowable blood loss (MABL) formula, we calculated the percentage of hemorrhage. Finally the patients' hemorrhage was categorized into three groups (< 10%, 10-20%, > 20%). The surgeon's satisfaction from surgical field was calculated according to the Visual Analogue Scale. Then the data was statistically analyzed with T-test. Results: There were meaningful differences between average of hemorrhage (propofol group = 155cc, and Isoflurane group = 291.3cc; P = 0.003), and surgeon's satisfaction (propofol group = 1.9 and Isoflurane group = 2.95; P = 0.007).
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objective: The study's key objective is to compare the propofol-based total intravenous anesthesia (TIVA) with isoflurane-based inhalational anesthesia for controlled hypotension during functional endoscopic sinus surgery (FESS). Methods: This study was a prospective randomized and controlled single-blinded clinical study. The study involved 40 patients posted for elective FESS surgery, selected randomly from the ENT department. Anesthesia was induced with Inj. Midazolam 2 mg, Inj. Fentanyl 2 µg/kg, Inj. Propofol 2 mg/kg, Inj. Vecuronium 0.1 mg/kg was ventilated using oxygen, air, and Isoflurane (FiO 2 of 0.5) in patients with isofurane. Injections of 2 mg of midazolam, 2 µg/kg of fentanyl,2 mg/kg propofol, and 0.1 mg/kg vecuronium, as well as oxygen and air for ventilation, were used to induce anesthesia (FIO2 of 0.5) in TIVA group patients. Fromme boezaart scale was used as an evaluation scale for surgical site bleeding. Results: The average blood loss in the isoflurane group was 134.25±4.65 ml and in the propofol group was 66.95±4.28 ml. The quality of the surgical field in the propofol group is (3.13±0.9), and in the isoflurane group is (3.13±0.8). The results are significant. Conclusion: Total intravenous anesthesia using propofol provides notable advantages over the traditionally used inhalational anesthetic technique using isoflurane in surgical field conditions and intraoperative blood loss.