Quality of recovery in patients undergoing endoscopic sinus surgery after general anesthesia: total intravenous anesthesia vs desflurane anesthesia

2018 ◽  
Vol 9 (3) ◽  
pp. 248-254 ◽  
Author(s):  
Tingjie Liu ◽  
Yurong Gu ◽  
Kaizheng Chen ◽  
Xia Shen
Keyword(s):  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Total Intravenous Anesthesia ◽  
Sinus Surgery ◽  
Intravenous Anesthesia ◽  
Quality Of Recovery

Ultrasound-guided Multilevel Paravertebral Blocks and Total Intravenous Anesthesia Improve the Quality of Recovery after Ambulatory Breast Tumor Resection

2014 ◽  
Vol 120 (3) ◽  
pp. 703-713 ◽  
Author(s):  
Faraj W. Abdallah ◽  
Pamela J. Morgan ◽  
Tulin Cil ◽  
Andrew McNaught ◽  
Jaime M. Escallon ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Breast Tumor ◽  
Tumor Resection ◽  
Total Intravenous Anesthesia ◽  
Control Group ◽  
Discharge Time ◽  
Intravenous Anesthesia ◽  
Quality Of Recovery ◽  
Pain Scores

Abstract Background: Regional anesthesia improves postoperative analgesia and enhances quality of recovery (QoR) after ambulatory surgery. This randomized, double-blinded, parallel-group, placebo-controlled trial examines the effects of multilevel ultrasound-guided paravertebral blocks (PVBs) and total intravenous anesthesia on QoR after ambulatory breast tumor resection. Methods: Sixty-six women were randomized to standardized general anesthesia (control group) or PVBs and propofol-based total intravenous anesthesia (PVB group). The PVB group received T1–T5 PVBs with 5 ml of 0.5% ropivacaine per level, whereas the control group received sham subcutaneous injections. Postoperative QoR was designated as the primary outcome. The 29-item ambulatory QoR tool was administered in the preadmission clinic, before discharge, and on postoperative days 2, 4, and 7. Secondary outcomes included block success, pain scores, intra- and postoperative morphine consumption, time to rescue analgesia, incidence of nausea and vomiting, and hospital discharge time. Results: Data from sixty-four patients were analyzed. The PVB group had higher QoR scores than control group upon discharge (146 vs. 131; P < 0.0001) and on postoperative day 2 (145 vs. 135; P = 0.013); improvements beyond postoperative day 2 lacked statistical significance. None of the PVB group patients required conversion to inhalation gas–based general anesthesia or experienced block-related complications. PVB group patients had improved pain scores on postanesthesia care unit admission and discharge, hospital discharge, and postoperative day 2; their intraoperative morphine consumption, incidence of nausea and vomiting, and discharge time were also reduced. Conclusion: Combining multilevel PVBs with total intravenous anesthesia provides reliable anesthesia, improves postoperative analgesia, enhances QoR, and expedites discharge compared with inhalational gas- and opioid-based general anesthesia for ambulatory breast tumor resection.

scholarly journals A Comparison of the Sevoflurane and Total Intravenous Anesthesia on the Quality of Recovery in 2 to 10-Year-Old Children

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Dariush Sheikhzade ◽  
Mehdi Razaghipour ◽  
Mahin Seyedhejazi ◽  
Behzad Aliakbari Sharabiani ◽  
Marzieh Marahem
Keyword(s):  
General Anesthesia ◽  
Outpatient Surgery ◽  
Pediatric Anesthesia ◽  
Demographic Characteristics ◽  
Nausea And Vomiting ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Sevoflurane Group ◽  
Quality Of Recovery

Background: Inhalant anesthesia is one of the mainstays of pediatric anesthesia, and it is considered by the majority of pediatric anesthetists worldwide as the gold standard. On the other hand, total intravenous anesthesia (TIVA) is a very popular choice for routine pediatric anesthesia practice. Therefore, utilization of TIVA compared to the volatile anesthesia is still a topic of debate in successful anesthesia management. Objectives: To compare TIVA vs sevoflurane-based anesthesia on the quality of recovery in children aged 2 to 10 years who had outpatient surgery. Methods: Eighty children, aged 2 to 10 years old undergoing outpatient surgery, were randomly divided into two groups (40 patients each). The TIVA group with propofol (T) received general anesthesia induced with midazolam 0.03 - 0.05 mg/kg, fentanyl 1 mcg/kg, propofol 3 - 5 mg/kg, 0.1 mg/kg lidocaine and maintenance with propofol 100 to 250 μg/kg.min and remifantanil 0.1 mcg/kg. The sevoflurane (S) group received general anesthesia induced with midazolam 0.03 - 0.05 mg/kg, fentanyl 1 mcg/kg, O2/sevoflurane 8 vol%, maintenance with 2 - 3 vol%. Demographic characteristics, awakening quality in recovery, hemodynamic status, and other complications such as patient agitation, pain, nausea, and vomiting were evaluated in both groups. Results: Patients did not differ significantly in terms of demographic characteristics. The incidence of postoperative agitation was 62% higher in the sevoflurane group than the TIVA group (5%, P < 0.001). The highest percentage of pain was obtained as 52.5% in the sevoflurane group. Postoperative nausea and vomiting did not differ significantly among groups, and there was a significant decrease in the heart rate of the subjects in the T group as one of the hemodynamic variables (P = 0.01). Conclusions: Inhalation anesthesia with sevoflurane led to more rapid recovery from anesthesia, and TIVA with propofol injection reduced post-operative pain and agitation compared to patients receiving sevoflurane. Therefore, TIVA with propofol infusion is probably an effective technique to maintain general anesthesia in pediatric outpatient surgery and to increase parental satisfaction, and to reduce the workload of recovery room staff.

scholarly journals Survey of anesthesiologists on anesthetic maintenance techniques and total intravenous anesthesia for endoscopic sinus surgery

2019 ◽  
Vol 10 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Yuki Yoshiyasu ◽  
Veronica F. Lao ◽  
Samuel Schechtman ◽  
Douglas A. Colquhoun ◽  
Sabrina Dhillon ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Total Intravenous Anesthesia ◽  
Sinus Surgery ◽  
Intravenous Anesthesia ◽  
Maintenance Techniques

scholarly journals Patient quality of recovery on the day of surgery after propofol total intravenous anesthesia for vitrectomy

Medicine ◽  
2018 ◽  
Vol 97 (40) ◽  
pp. e12699 ◽  
Author(s):  
Se Hee Na ◽  
Kyu Hee Jeong ◽  
Dahae Eum ◽  
Jin Ha Park ◽  
Min-Soo Kim
Keyword(s):  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Quality Of Recovery

The Effect of the Total Intravenous Anesthesia Compared with Inhalational Anesthesia on the Surgical Field during Endoscopic Sinus Surgery

2005 ◽  
Vol 19 (5) ◽  
pp. 514-520 ◽  
Author(s):  
Peter J. Wormald ◽  
Graham van Renen ◽  
Jonathon Perks ◽  
Janine A. Jones ◽  
Claire D. Langton-Hewer
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Controlled Trial ◽  
Total Intravenous Anesthesia ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Allergic Fungal Sinusitis ◽  
Surgical Field

Background Bleeding during endoscopic sinus surgery (ESS) may increase complications and negatively effect the surgery and its outcome. The aim of this study was to compare the surgical field in patients in whom total intravenous anesthesia (TIVA) is used as opposed to inhalation anesthesia. A prospective randomized controlled trial was performed. Methods Fifty-six patients undergoing ESS were randomly assigned to receive either inhaled sevoflurane with incremental doses offentanyl (n = 28) or TIVA via a propofol and remifentanil infusion (n = 28) for their general anesthesia. The surgical field was graded every 15 minutes using a validated scoring system. Results The two groups were matched for surgical procedure and computed tomography scores. Patients in the TIVA group were found to have a significantly lower surgical grade score than in the sevoflurane group (p < 0.001). Surgical grade score increased with time in both groups. Mean arterial pressure and pulse were found to influence the surgical field independently (p = 0.003 and p = 0.036 respectively). Mean surgical field grade scores were higher in the patients with allergic fungal sinusitis and nasal polyposis as opposed to chronic rhinosinusitis without polyps or fungus. Lund-Mackay computed tomography scores were found to correlate positively with surgical grade (Spearman rank correlation, p = 0.001). Conclusion In patients undergoing ESS, TIVA results in a better surgical field than inhalational anesthesia.

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