Effects of inhalation anesthesia versus total intravenous anesthesia on femoral venous flow during laparoscopic cholecystectomy


Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2014

Student: ŞAHİKA UÇAR AKDEMİR

Supervisor: ÖMER KURTİPEK

Abstract:

The aim of this prospective, randomised study is to compare the effects of ihalation anesthesia and total intravenous anesthesia (TIVA) on femoral venous flow postoperative shoulder pain, nausea and vomiting and patient satisfaction. 60 (ASA I-II) patients undergoing elective laparoscopic cholecystectomy were randomly assigned to 2 groups; inhalation (Group I, n=30) or TIVA (Group T, n=30) group. In both groups, anesthesia was induced with intravenous 1 mg/kg lidocain, 2 mg/kg propofol, 0,6 mg/kg rokuronyum, 2 µgr/kg remifentanil infusion and ventilation was adjusted in %60 air, %40 O₂ mixture with 10-12/min frequency and 6-8 ml/kg tidal volume. Hearth beat rate, systolic arterial pressure, diastolic arterial pressure and oxygen saturation were recorded periodically from beginning of the operation till the end of the operation. End tidal carbondioxide levels were noted simultaneous with the other parameters after the intubation. The doppler measurements were performed by another anesthesiologist who had experience in doppler USG. Measurements were performed preoperative (supine position), after the induction (supine position), before the gas insufflation (Reverse trandelenburg 30˚ left ), after the gas insufflation (Reverse trandelenburg 30˚ left ), before desuflation (Reverse trandelenburg 30˚ left ) and after desufflation (supine position). We concluded that; TIVA effects femoral venous flow and femoral venous diameter less than inhalation anesthesia, with more stable vital parameters. Postoperative vomiting and nausea are less and patient satisfaction is more in TIVA group compaired to inhalation group. In conclution, TIVA maintains more effective and safe anesthesia in laparoscopic cholecystectomy.