scholarly journals A Comparison of the Effect of Total Intravenous Anaesthesia with Propofol and Remifentanil and Inhalational Anaesthesia with Isoflurane on the Release of Pro- and Anti-Inflammatory Cytokines in Patients Undergoing Open Cholecystectomy

2008 ◽  
Vol 36 (1) ◽  
pp. 74-78 ◽  
Author(s):  
J. J. Ke ◽  
J. Zhan ◽  
X. B. Feng ◽  
Y. Wu ◽  
Y. Rao ◽  
...  
Keyword(s):  
Inflammatory Cytokines ◽  
Open Cholecystectomy ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Inhalational Anaesthesia ◽  
Anti Inflammatory

scholarly journals To observe the changes of optic nerve sheath diameter following the use of total intravenous anaesthesia with propofol or inhalational anaesthesia with desflurane during laparoscopic surgeries

2021 ◽  
Vol 8 (4) ◽  
pp. 515-520
Author(s):  
Pratikkumar Patel ◽  
Vijay Mathur ◽  
Shruti Singhal ◽  
Durga Jethava
Keyword(s):  
Laparoscopic Surgery ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Total Intravenous Anaesthesia ◽  
Trendelenburg Position ◽  
Intravenous Anaesthesia ◽  
Nerve Sheath ◽  
Inhalational Anaesthesia ◽  
The Mean

Optic nerve sheath diameter measurement is a simple, non-invasive and yet accurate intracranial pressure (ICP) assessment technique during laparoscopic surgery. The pneumoperitoneum induced by insufflating carbon-dioxide and steep angle of trendelenburg position is associated with physiological changes resulting in increased ICP during laparoscopic surgery. We aimed to observe the changes of ONSD (surrogate marker of ICP) following the use of total intravenous anaesthesia in comparison to desflurane during laparoscopic surgery.Patients scheduled for elective laparoscopic surgery were randomly assigned to the TIVA or DES group in this randomized study. Ultrasonographic measurements of ONSD were conducted before administration of anaesthesia (T0), 10 mins, 30 mins, 1 hr after the trendelenburg position (T1,T2,T3), 5mins after resuming the supine position (T4) and at post-anaesthetic care unit (T5). The primary outcome measure was the comparison of the mean ONSD of both the eyes of the patients of both the groups that is TIVA versus DES (inhalational anaesthetic) group.A total of 60 patients were analysed in our study. The mean ONSD value at T1, T2, T3 and T4 (for right eye p=0.002,0.001,<0.01,0.03 respectively and for left eye p=0.004,<0.01,<0.01,0.02 respectively) were significantly lower for patients in TIVA group as compared with those in DES group.Our result suggests that TIVA may be a better option than inhalational anaesthesia to prevent rise in intracranial pressure in patients undergoing laparoscopic surgery and preventing devastating complications caused by raised intracranial pressure in succeptible patients.

scholarly journals Inhalational versus Propofol-Based Total Intravenous Anaesthesia: Practice Patterns and Perspectives among Australasian Anaesthetists

2018 ◽  
Vol 46 (5) ◽  
pp. 480-487 ◽  
Author(s):  
A. Lim ◽  
S. Braat ◽  
J. Hiller ◽  
B. Riedel
Keyword(s):  
Practice Patterns ◽  
Controlled Trial ◽  
Significant Proportion ◽  
Cancer Surgery ◽  
Sufficient Evidence ◽  
Perioperative Outcomes ◽  
Total Intravenous Anaesthesia ◽  
Cancer Outcomes ◽  
Intravenous Anaesthesia ◽  
Inhalational Anaesthesia

Increasing evidence suggests that total intravenous anaesthesia (TIVA) may be the preferred anaesthetic for cancer resection surgery. To assist the preparation of a randomised controlled trial (RCT) examining Volatile (versus TIVA) Anaesthesia and Perioperative Outcomes Related to Cancer (VAPOR-C) we developed an 18-question electronic survey to investigate practice patterns and perspectives (emphasising indications, barriers, and impact on cancer outcomes) of TIVA versus inhalational general anaesthesia in Australasia. The survey was emailed to 1,000 (of 5,300 active Fellows) randomly selected Australian and New Zealand College of Anaesthetists (ANZCA) Fellows. The response rate was 27.5% (n=275). Of the respondents, 18% use TIVA for the majority of cases. In contrast, 46% use TIVA 20% of the time or less. Respondents described indications for TIVA as high risk of nausea, neurosurgery, and susceptibility to malignant hyperthermia. Lack of equipment, lack of education and cost were not considered barriers to TIVA use, and a significant proportion (41%) of respondents would use TIVA more often if setup were easier. Of the respondents, 43% thought that TIVA was associated with less cancer recurrence than inhalational anaesthesia, while 46% thought that there was no difference. Yet, only 29% of respondents reported that they use TIVA often or very often for cancer surgery. In Australasia, there is generally a low frequency of TIVA use despite a perception of benefit when compared with inhalational anaesthesia. Anaesthetists are willing to use TIVA for indications where sufficient evidence supports a meaningful level of improvement in clinical outcome. The survey explores attitudes towards use of TIVA for cancer surgery and demonstrates equipoise in anaesthetists’ opinions regarding this indication. The inconsistent use of TIVA in Australasia, minimal barriers to its use, and the equipoise in anaesthetists’ opinions regarding the effect of TIVA versus inhalational anaesthesia on cancer outcomes support the need for a large prospective RCT.

Comparison of Total Intravenous, Balanced Inhalational and Combined Intravenous-Inhalational Anaesthesia for Tympanoplasty, Septorhinoplasty and Adenotonsillectomy

1995 ◽  
Vol 23 (5) ◽  
pp. 574-582 ◽  
Author(s):  
A. A. Van Den Berg ◽  
D. Savva ◽  
N. M. Honjol ◽  
N. V. Rama Prabhu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Anaesthetic Techniques ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Haemodynamic Stability ◽  
Inhalational Anaesthetic ◽  
Inhalational Anaesthesia ◽  
Intravenous Anaesthetic ◽  
Induction Of Anaesthesia

Two hundred and thirty-five consecutive Saudi patients aged between two and fifty-three years undergoing elective tympanoplasty (n = 32), septorhinoplasty (n = 68) or adenotonsillectomy (n=135) were studied. They were randomized to receive either a total intravenous anaesthetic (10 ears, 23 noses, 44 throats) consisting of propofol for induction of anaesthesia followed by a propofol infusion, a combined intravenous-inhalational anaesthetic (11 ears, 22 noses, 46 throats) consisting of the above with isoflurane in oxygen-enriched air, or a balanced inhalational anaesthetic (11 ears, 23 noses, 45 throats) consisting of thiopentone for induction of anaesthesia and oxygen in nitrous oxide with isoflurane for maintenance. During tympanoplasty, all three anaesthetic techniques produced stable heart rates and arterial pressures. During septorhinoplasty, blood pressure rose in patients who received total intravenous anaesthesia, while combined and balanced techniques produced haemodynamic stability. During adenotonsillectomy, total intravenous anaesthesia produced a rise in both heart rate and blood pressure, the combined technique produced a rise in heart rate alone while balanced anaesthesia produced haemodynamic stability. Postoperatively, vomiting, pain scores and analgesic requirements were similar following all three types of anaesthetic within each surgical site subgroup. Our findings support the choice of balanced inhalational anaesthesia for all three types of ENT surgery and, where cost and facilities permit, total intravenous anaesthesia for tympanoplasty and combined intravenous-inhalational anaesthesia for septorhinoplasty.

Sign in / Sign up

Export Citation Format

Share Document