Total intravenous anesthesia produces outcomes superior to those with combined intravenous-inhalation anesthesia for laparoscopic gynecological surgery at high altitude

J Int Med Res. 2017 Feb;45(1):246-253. doi: 10.1177/0300060516687230. Epub 2017 Jan 25.

Abstract

Objective We compared efficacy and adverse outcomes following totally intravenous anesthesia (TIVA) versus combined intravenous-inhalation anesthesia (CIVIA) on hemodynamics and postoperative recovery following laparoscopic gynecological (LG) surgery at high altitudes. Methods We enrolled 80 ASA I or II patients scheduled for LG surgery and randomly assigned them to TIVA with propofol (group P, n = 40) or CIVIA with isoflurane (group I, n = 40). Mean arterial pressure, heart rate, pulse oxygen saturation, and partial pressure of end-tidal carbon dioxide were measured at various time points. Outcome measures were interval to spontaneous ventilation, eye opening, return to consciousness, extubation, operating room duration. Intraoperative awareness and postoperative nausea/vomiting were assessed at follow-up. Results No differences in hemodynamic parameters were detected in either group. Group P had a significantly shorter postoperative anesthetic recovery time and lower incidence of postoperative nausea/vomiting. Conclusion TIVA is superior to CIVIA for GL surgery at high altitudes.

Keywords: TIVA; anesthesia; gynecological surgery; intravenous–inhalation anesthesia; laparoscopy; postoperative recovery.

MeSH terms

  • Adolescent
  • Adult
  • Altitude
  • Anesthesia Recovery Period
  • Anesthesia, Intravenous
  • Anesthetics, Inhalation*
  • Anesthetics, Intravenous*
  • Blood Pressure / physiology
  • Female
  • Gynecologic Surgical Procedures*
  • Heart Rate / physiology
  • Hemodynamics / physiology
  • Humans
  • Intraoperative Awareness / diagnosis
  • Isoflurane*
  • Laparoscopy
  • Middle Aged
  • Operative Time
  • Pain / physiopathology
  • Pain / prevention & control*
  • Postoperative Nausea and Vomiting / diagnosis
  • Postoperative Nausea and Vomiting / physiopathology
  • Propofol*
  • Prospective Studies
  • Tibet
  • Treatment Outcome

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Isoflurane
  • Propofol