Total Intravenous Anesthesia and Anesthetic Outcomes

Miller, Timothy E.; Gan, Tong J.

doi:10.1053/j.jvca.2015.01.022

Cited by 25 publications

(23 citation statements)

References 58 publications

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“…Opioids are part of the multimodal anesthesia regimen for the management of pain during and after surgery. One of these opioids, remifentanil, is often used because of its favorable pharmacokinetic and pharmacodynamic properties, including fast onset and offset of action, predictable rapid recovery profile independent of infusion duration, and metabolism independent of kidney or liver function …”

Section: Introductionmentioning

confidence: 99%

“…One of these opioids, remifentanil, is often used because of its favorable pharmacokinetic and pharmacodynamic properties, including fast onset and offset of action, predictable rapid recovery profile independent of infusion duration, and metabolism independent of kidney or liver function. 1,2 Recently, however, opioids, and remifentanil in particular, have been associated with opioid-induced hyperalgesia, or acute opioid tolerance. 1,3 Concerning remifentanil, its ultra-short half-life, resulting in abrupt analgesic offset after cessation of the infusion, is thought to contribute to high postoperative pain levels.…”

Section: Introductionmentioning

confidence: 99%

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Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery

et al. 2017

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“…Propofol-based TIVA has been associated with improved recovery profile and lower costs compared to sevoflurane for office-based anesthesia. This resulted in shorter recovery room stay, earlier discharge, and more patient satisfaction (20).…”

Section: Discussionmentioning

confidence: 99%

“…Propofol that is commonly used in total intravenous anesthesia (TIVA) has anti-oxidant and inflammatory inhibition properties (17)(18)(19). It is known that TIVA can decrease postoperative nausea and vomiting (PONV) (20) with little effects on pulmonary functions (21).…”

Section: Introductionmentioning

confidence: 99%

“…Some researchers have preferred TIVA to inhalational anesthesia for the prevention of PONV or chronic pain relief after anesthesia (20) while others found no significant differences between propofol-based TIVA and inhalational sevoflurane anesthesia in terms of postoperative pain, PONV, narcotic administration, and recovery time (17). Mensil et al in a study on ICU patients concluded that long-term sedation using inhaled sevoflurane was safer and more effective than intravenous propofol, as it significantly reduced wake-up and extubation times and increased awakening quality (26).…”

Section: Introductionmentioning

confidence: 99%

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Effect of Intravenous Propofol and Inhaled Sevoflurane Anesthesia on Postoperative Spirometric Indices: A Randomized Controlled Trial

et al. 2019

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Background: Anesthetic drugs may directly or indirectly affect respiratory function. We investigated the effects of intravenous propofol and inhaled sevoflurane anesthesia on postoperative spirometric indices in patients undergoing inguinal herniorrhaphy surgery. Methods: We randomly assigned 111 patients, aged 18-65 years, undergoing inguinal herniorrhaphy surgery, to receive either intravenous propofol or inhaled sevoflurane. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC were measured before and after anesthesia. Comparisons between the two groups were made using the t-test and ANOVA. Results: There were no significant differences between the two groups in terms of age, sex, height, body weight, BMI, pain score, ASA class, operation duration, and received analgesics. The FEV1 and FVC values significantly decreased after the operation in the sevoflurane group. Conclusions: Both intravenous propofol and inhaled sevoflurane can decrease postoperative spirometry parameters. However, it seems that patients receiving propofol have less decreased spirometric indices.

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Total Intravenous Anesthesia Versus Inhaled Sevoflurane in Obstructive Sleep Apnea Surgery: A Randomized Controlled Trial

et al. 2022

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Objective Specific guidelines regarding an optimal general anesthesia (GA) approach to obstructive sleep apnea (OSA) patients remain undefined. Literature comparing the efficacy of total intravenous anesthesia (TIVA) and inhalational anesthesia in this population is sparse. We hypothesize that OSA patients receiving TIVA will experience reduced recovery times and other improved post‐surgical outcomes. Study Design Randomized controlled trial. Methods Adult OSA patients undergoing upper airway surgery (hypoglossal nerve stimulation [HNS], nasal, or palate surgery) from February 2020–December 2020 were included. A post‐anesthesia care unit (PACU) nursing survey documented patients' alertness, pain, oxygen supplementation, and postoperative nausea and vomiting from PACU arrival to 2 hours. Perioperative timepoints from the electronic medical record (EMR) and a nurse‐estimated Phase I recovery time were collected. Results One hundred eleven patients were included (46 TIVA and 65 inhalational anesthesia). Per EMR‐recorded timepoints, TIVA patients undergoing HNS and palate surgery experienced Phase I Time reductions of 12.5 min (p = 0.042) and 27.5 min (p = 0.016), respectively. Per the PACU survey, TIVA patients undergoing any surgery, HNS, or palate surgery experienced nurse‐estimated Phase I Time reductions of 16.5 min (p = 0.004), 12.5 min (p = 0.031), and 38.5 min (p = 0.024), respectively. Overall, TIVA patients experienced higher alertness and pain ratings, and lower oxygen supplementation requirements from PACU arrival to 30 min (p < 0.05). Conclusion Patients with OSA receiving TIVA for GA maintenance during upper airway procedures experienced reduced recovery times and oxygen supplementation requirements, and a more rapid return to alertness. Future work toward developing optimized anesthetic guidelines for OSA patients is merited. Level of Evidence 3 Laryngoscope, 133:984–992, 2023

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Total Intravenous Anesthesia and Anesthetic Outcomes

Cited by 25 publications

References 58 publications

Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery

Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery

Effect of Intravenous Propofol and Inhaled Sevoflurane Anesthesia on Postoperative Spirometric Indices: A Randomized Controlled Trial

Total Intravenous Anesthesia Versus Inhaled Sevoflurane in Obstructive Sleep Apnea Surgery: A Randomized Controlled Trial

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