Saurabh SHARMA
(Sree Chitra Tirunal Institute for Medical Sciences and Technology)
Anju Romina BHALOTRA
Shikha AWAL
(Kalinga Hospital, Bhubaneswar)
Yıl: 2020Cilt: 48Sayı: 1ISSN: 2667-677X / 2667-6370Sayfa Aralığı: 17 - 23İngilizce

28 0
Changes in Lung Function Parameters after Total Intravenous Anaesthesia and Balanced Anaesthesia with Desflurane: A Prospective Randomised Study
Objective: Following anaesthesia, there is a decrease in pulmonary function. Unlike volatile anaesthetics, propofol decreases the upper airway tone, and total intravenous anaesthesia (TIVA) with propofol may decrease coughing on emergence. Coughing may reduce postoperative atelectasis. Thus, TIVA may lead to greater decreases in lung function postoperatively as compared to balanced anaesthesia with desflurane. Methods: Sixty patients of either sex, aged 18-60 years and American Society of Anaesthesiologists (ASA) status I/II, who were to undergo mastoid surgery, were randomly allocated to Group B and Group T. Anaesthesia was maintained with desflurane, nitrous oxide and oxygen in Group B, and with TIVA in Group T. Pulmonary function tests (PFT) were done preoperatively, and 1, 3 and 24 hours postoperatively. Results: Demographic data and preoperative PFT were comparable in both groups. One hour after surgery, there was a greater decrease in FEV1 and peak expiratory flow rate (PEFR) in Group T (p=0.044 and 0.042, respectively). Three hours postoperatively, the decrease in MEFR and PEFR was again greater in Group T (p=0.005 and 0.008, respectively), while the MEFR recovered to preoperative values in Group B. By 24 hours, the forced vital capacity (FVC), MEFR and PEFR recovered to preoperative values in Group T, while FVC remained reduced in Group B (p=0.006). Conclusion: Both anaesthetic techniques cause a postoperative impairment in the lung function, but while TIVA causes a greater reduction in PFT in the early postoperative period, recovery is also earlier. On the other hand, balanced anaesthesia with desflurane was associated with a greater reduction in PFT at 24 hours.
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DergiAraştırma MakalesiErişime Açık
  • 1. Von Ungern-Sternberg BS, Regli A, Reber A, Schneider MC. Comparison of perioperative spirometric data following spinal or general anaesthesia in normal-weight and overweight gynaecological patients. Acta Anaesthesiol Scand 2005; 49: 940-8. [CrossRef]
  • 2. Tiefenthaler W, Pehboeck D, Hammerle E, Kavakebi P, Benzer A. Lung function after total intravenous anaesthesia or balanced anaesthesia with sevoflurane. Br J Anaesth 2010; 106: 272-6. [CrossRef]
  • 3. Hohlrieder M, Tiefenthaler W, Klaus H, Gabl M, Kavakebi P, Keller C, et al. Effect of total intravenous anaesthesia and balanced anaesthesia on the frequency of coughing during emergence from the anaesthesia. Br J Anaesth 2007; 99: 587- 91. [CrossRef]
  • 4. Zoremba M, Dette F, Hunecke T, Eberhart L, Braunecker S, Wulf H. A comparison of desflurane versus propofol: the effects on early postoperative lung function in overweight patients. Anesth Analg 2011; 113: 63-9. [CrossRef]
  • 5. von Ungern-Sternberg BS, Regli A, Schneider MC, Kunz F, Reber A. Effect of obesity and site of surgery on perioperative lung volumes. Br J Anaesth 2004; 92: 202-7. [CrossRef]
  • 6. Craig DB. Postoperative recovery of pulmonary function. Anesth Analg 1981; 60: 46-52. [CrossRef]
  • 7. Diament ML, Palmer KN. Postoperative changes in gas tensions of arterial blood and in ventilatory function. Lancet 1966; 7456: 180-2. [CrossRef]
  • 8. Rothen HU, Sporre B, Engberg G, Wegenius G, Reber A, Hedenstierna G. Prevention of atelectasis during general anaesthesia. Lancet 1995; 345: 1387-91. [CrossRef]
  • 9. Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Postoperative pulmonary function after laparoscopic and open cholecystectomy. Br J Anaesth 1996; 77: 448- 52. [CrossRef]
  • 10. Joris J, Kaba A. Postoperative spirometry after laparoscopy for lower abdominal or upper abdominal surgical procedures. Br J Anaesth 1997; 79: 422-6. [CrossRef]
  • 11. Magnusson L, Tenling A, Lemoine R, Hogman M, Tyde’n H, Hedenstierna G. The safety of one, or repeated, vital capacity maneuvers during general anaesthesia. Anesth Analg 2000; 91: 702-7. [CrossRef]
  • 12. Jensen AG, Kalman SH, Eintrei C, Fransson SG, Morales O. Atelectasis and oxygenation in major surgery with either propofol with or without nitrous oxide or isoflurane anaesthesia. Anaesthesia 1993; 48: 1094-6. [CrossRef]
  • 13. Dikmen Y, Eminoglu E, Salihoglu E, Demiroluk S. Pulmonary mechanics during isoflurane, sevoflurane and desflurane anaesthesia. Anaesthesia 2003; 58: 745-8. [CrossRef]
  • 14. Peratoner A, Nascimento CS, Santana MC, Cadete RA, Negri EM, Gullo A, et al. Effects of propofol on respiratory mechanic and lung histology innormal rats. Br J Anaesth 2004; 92: 737- 40. [CrossRef]
  • 15. Uhlig C, Bluth T, Schwarz K, Deckert S, Heinrich L, De Hert S, et al. Effects of Volatile Anesthetics on Mortality and Postoperative Pulmonary and Other Complications in Patients Undergoing Surgery. A Systematic Review and Meta-analysis. Anesthesiology 2016; 124: 1230-45. [CrossRef]

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