Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

Chan, Wai Hong; Lee, Meei-Shyuan; Lin, Chin; Lai, Hou-Chuan; Chan, Shun-Ming; Lu, Chueng-He; Cherng, Chen‐Hwan; Wu, Zhi-Fu

doi:10.1371/journal.pone.0165407

Cited by 20 publications

(22 citation statements)

References 43 publications

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“…The result of multivariable linear regressions showed that patients with younger age, female, lower BMI and non-DES anesthesia regimen resulted in prolonged extubation time, which contradicted previous studies [ 1 , 16 , 21 , 22 ]. Lai et al reported that older age, male, higher BMI, and longer anesthesia time contribute to slower emergence in open major upper abdominal surgery [ 1 ].…”

Section: Discussioncontrasting

confidence: 64%

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Zhang

et al. 2018

BMC Anesthesiol

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BackgroundThis study aimed to determine whether the use of desflurane (DES) anesthesia combined with bispectral index (BIS) monitoring and warming is effective in reducing anesthesia-controlled operating room time (ACT) in patients undergoing lengthy abdominal surgery.MethodsSeventy patients, 40 years of age or older, undergoing abdominal surgery expected to last three to five hours were randomly assigned to the DES group (n = 35) or the control group (n = 35). Patients in the DES group were maintained with desflurane anesthesia and received BIS monitoring and warming. Patients in the control group were given non-desflurane anesthesia for maintenance, and the usage of BIS monitoring and warming were not mandatory and determined by anesthesia care providers. Early postoperative recovery times were recorded.ResultsThe times to extubation (8.8 ± 8.5 vs 14.7 ± 13.7 min, P = 0.035), eye opening (8.4 ± 8.6 vs 14.4 ± 13.4 min, P = 0.028), responds on command (8.2 ± 8.5 vs 14.4 ± 13.0 min, P = 0.022), and the ACT (23.8 ± 11.4 vs 32.7 ± 15.4 min, P = 0.009) were significantly less in the DES group than that in the control group. The postanesthesia care unit (PACU) length of stay, incidence of prolonged extubation, and surgeon and anesthesiologist satisfaction were similar in two groups. Also, the result of multivariable linear regressions showed that patients who were younger, female, lower BMI and non-DES anesthesia regimen resulted in prolonged extubation.ConclusionsDesflurane anesthesia combined with BIS monitoring and warming is associated with early postoperative recovery in lengthy abdominal surgery.Trial registrationChiCTR-INR-17013333. Date of registration: November 11, 2017.

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Section: Discussioncontrasting

confidence: 64%

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Zhang

et al. 2018

BMC Anesthesiol

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“…Some prior works have focused on analysis of single specific anesthetic agent [ 12 , 46 ]. It is worthwhile using advanced algorithms to study the comparison between these two drugs although some research groups have made spectrogram relevant comparisons between propofol and desflurane [ 47 – 49 ]. It is noticed that both propofol and desflurane generally appear similar in the spectrogram fluctuations.…”

Section: Discussionmentioning

confidence: 99%

Frontal EEG Temporal and Spectral Dynamics Similarity Analysis between Propofol and Desflurane Induced Anesthesia Using Hilbert-Huang Transform

Liu

Fan

et al. 2018

BioMed Research International

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Electroencephalogram (EEG) signal analysis is commonly employed to extract information on the brain dynamics. It mainly targets brain status and communication, thus providing potential to trace differences in the brain's activity under different anesthetics. In this article, two kinds of gamma-amino butyric acid (type A -GABAA) dependent anesthetic agents, propofol and desflurane (28 and 23 patients), were studied and compared with respect to EEG spectrogram dynamics. Hilbert-Huang Transform (HHT) was employed to compute the time varying spectrum for different anesthetic levels in comparison with Fourier based method. Results show that the HHT method generates consistent band power (slow and alpha) dominance pattern as Fourier method does, but exhibits higher concentrated power distribution within each frequency band than the Fourier method during both drugs induced unconsciousness. HHT also finds slow and theta bands peak frequency with better convergence by standard deviation (propofol-slow: 0.46 to 0.24; theta: 1.42 to 0.79; desflurane-slow: 0.30 to 0.25; theta: 1.42 to 0.98) and a shift to relatively lower values for alpha band (propofol: 9.94 Hz to 10.33 Hz, desflurane 8.44 Hz to 8.84 Hz) than Fourier one. For different stage comparisons, although HHT shows significant alpha power increases during unconsciousness stage as the Fourier did previously, it finds no significant high frequency (low gamma) band power difference in propofol whereas it does in desflurane. In addition, when comparing the HHT results within two groups during unconsciousness, high beta band power in propofol is significantly larger than that of desflurane while delta band power behaves oppositely. In conclusion, this study convincingly shows that EEG analyzed here considerably differs between the HHT and Fourier method.

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“…As a retrospective study, the cases we collected were performed under routine clinical protocol, using 6 L/min of fresh gas flow during emergence. In our serial retrospective studies [ 5 – 8 , 13 – 15 ] TIVA delivered by TCI system has the advantage in predicting the propofol effect-site concentration at return of consciousness. [ 16 , 32 – 34 ] Moreover, TCI system could calculate the time required to reach such concentration, and therefore improve the OR efficiency.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, in our clinical practice, the fentanyl dosage was higher in the TIVA group than the DES group. [ 5 , 6 , 9 , 12 , 13 , 15 ]…”

Section: Limitationsmentioning

confidence: 99%

“…Finally, we did not use anesthesia depth monitors such as bispectral index (BIS) in our common practice. [ 5 , 7 , 8 , 13 – 16 ] Because, in the practice of most anesthesiologists in Taiwan, BIS is not routine used during minor surgeries such as breast cancer surgery or FESS. Moreover, before our collected data period, many studies have suggested an absence of benefit of BIS monitoring during clinical anesthesia.…”

Section: Limitationsmentioning

confidence: 99%

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Analysis of anesthesia-controlled operating room time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in functional endoscopic sinus surgery

Liu

Lai

et al. 2018

Medicine

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Anesthesia technique may contribute to the improvement of operation room (OR) efficiency by reducing anesthesia-controlled time. We compared the difference between propofol-based total intravenous anesthesia (TIVA) and desflurane anesthesia (DES) for functional endoscopic sinus surgery (FESS) undergoing general anesthesiaWe performed a retrospective study using data collected in our hospital to compare the anesthesia-controlled time of FESS using either TIVA via target-controlled infusion with propofol/fentanyl or DES/fentanyl-based anesthesia between January 2010 and December 2011. The various time intervals (surgical time, anesthesia time, extubation time, total OR stay time, post anesthesia care unit [PACU] stay time) and the percentage of prolonged extubation were compared between the 2 anesthetic techniques.We included data from 717 patients, with 305 patients receiving TIVA and 412 patients receiving DES. An emergence time >15 minutes is defined as prolonged extubation. The extubation time was faster (8.8 [3.5] vs. 9.6 [4.0] minutes; P = .03), and the percentage of prolonged extubation was lower (7.5% vs. 13.6%, risk difference 6.1%, P < .001) in the TIVA group than in the DES group. However, there was no significant difference between ACT, total OR stay time, and PACU stay time.In our hospital, propofol-based TIVA by target-controlled infusion provide faster emergence and lower chance of prolonged extubation compared with DES anesthesia in FESS. However, the reduction in extubation time may not improve OR efficiency.

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Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

Cited by 20 publications

References 43 publications

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Frontal EEG Temporal and Spectral Dynamics Similarity Analysis between Propofol and Desflurane Induced Anesthesia Using Hilbert-Huang Transform

Analysis of anesthesia-controlled operating room time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in functional endoscopic sinus surgery

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