Comparison of the effects of different general anesthetic techniques and agents on postoperative analgesia and complications

Abstract

The aim of this study was to compare the effects of total intravenous anesthesia (TIVA) and inhalational anesthesia on the first analgesic requirement time and postoperative complications. After institutional ethical committee approval 60 female patients, ASA I-II, ages between 30-60 years, undergoing total abdominal hysterectomy were randomly divided into three groups. For the induction of anesthesia; propofol 2 mg.kg-1 in Group I. midazolam 0.3 mg.kg-1 in Group II and thiopental 7 mg.kg-1 in Group III were administered intravenously. Also, alfentanil 25 ?g.kg-1 was given iv in Group I and II during induction of anesthesia. Endotracheal intubation was facilitated with 0.1 mg.kg-1 vecuronium in all groups. Anesthesia was maintained with propofol 9 mg.kg-1.h-1 for the first 30 minutes and then 4.5 mg.kg-1.h-1 for the rest of operation until 5 minutes before skin closure in Group I and midazolam 0.125 mg.kg-1.h-1 for the duration of operation until abdominal fascia closure in Group II. The Group III patients were taken 0.8-1.5% isoflurane. In Group I and II, alfentanil 25 ?g.kg-1.h-1 were infused until the abdominal fascia closure. In all groups 67% N2O in oxygen were given. The first time to verbal response, postoperative first analgesic requirement time and postoperative complications were noted. First analgesic requirement time was shorter in Group III than the others. Postoperative complications were more common in Group III. In conclusion; postoperative period confort of general anesthesia is best in TIVA.