Lung function after total intravenous anaesthesia or balanced anaesthesia with sevoflurane

Abstract

In patients emerging from general anaesthesia, postoperative reduction in FVC is greater after TIVA than after BAL with sevoflurane.

Effects of propofol or desflurane on post‐operative spirometry in elderly after knee surgery: a double‐blind randomised study

“…Reductions of FEV 1 , FVC, and FEF25–75 with TIVA and inhalational anaesthesia have been previously reported, but the degree of post‐operative reduction in FVC following TIVA was larger than that in sevoflurane anaesthesia . This result is inconsistent with our findings.…”

“…This finding may imply an attenuated lung function in the elderly that is more profound than in younger adults (the previous study involved patients 21–60 years of age, with no elderly patients included). Although there was a larger decrease in FVC in the TIVA group in the previous study, the authors did not compare the emergence time from anaesthesia of the two groups . The difference in the type of volatile agent (sevoflurane in the prior study, DES in the present study), anaesthetic time (approximately 50 min in the prior study and approximately 170 min in the present study), and patient age (about 40 years of age in the prior study and about 75 years of age in the present study) might affect the difference in emergence time.…”

“…In general, elderly individuals have decreased pulmonary function compared with younger individuals, and pneumonia is the most common perioperative complication in elderly patients . However, the decrease in post‐operative forced vital capacity (FVC) is greater after total intravenous anaesthesia (TIVA) with propofol‐remifentanil than after sevoflurane‐fentanyl‐nitrous oxide anaesthesia …”

“…Many anaesthetists use desflurane (DES) because of its rapid effect and dissipation . Advantages of TIVA include less post‐operative nausea and vomiting, coughing, reduction in FVC, and bronchoconstriction compared with inhalational anaesthesia . However, it remains unclear whether these attributes of TIVA are beneficial for respiratory parameters in elderly patients, or whether various other spirometry parameters are affected by TIVA or inhalational anaesthetics.…”

Total Intravenous Anesthesia and Anesthetic Outcomes

“…54 The study was performed in 60 patients undergoing lumbar disc surgery in the prone position. As in previous work on postoperative lung function, the investigators found that lung function parameters decreased after surgery irrespective of the type of anesthesia administered.…”