Quality of Recovery of Patients Who Underwent Curative Pancreatectomy: Comparison of Total Intravenous Anesthesia Versus Inhalation Anesthesia Using the QOR-40 Questionnaire

Author(s):  
Young-Eun Joe ◽  
Chang Moo Kang ◽  
Hye-Mi Lee ◽  
Ki-Jun Kim ◽  
Ho Kyoung Hwang ◽  
...  
Medicine ◽  
2018 ◽  
Vol 97 (40) ◽  
pp. e12699 ◽  
Author(s):  
Se Hee Na ◽  
Kyu Hee Jeong ◽  
Dahae Eum ◽  
Jin Ha Park ◽  
Min-Soo Kim

2014 ◽  
Vol 120 (3) ◽  
pp. 703-713 ◽  
Author(s):  
Faraj W. Abdallah ◽  
Pamela J. Morgan ◽  
Tulin Cil ◽  
Andrew McNaught ◽  
Jaime M. Escallon ◽  
...  

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.


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Dariush Sheikhzade ◽  
Mehdi Razaghipour ◽  
Mahin Seyedhejazi ◽  
Behzad Aliakbari Sharabiani ◽  
Marzieh Marahem

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.


2017 ◽  
Vol 44 (5) ◽  
pp. 1016-1026 ◽  
Author(s):  
PenTing Liao ◽  
Melissa Sinclair ◽  
Alexander Valverde ◽  
Cornelia Mosley ◽  
Heather Chalmers ◽  
...  

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