Vol. 3, Issue 4 (2014)

Author(s):
Latchireddy Srinivasa Rao and S CH Raghu Kumar

Abstract:
Background and Objectives: Ensuring maximum intraoperative stability and a seamless postoperative recovery are both greatly impacted by anesthetic administration. Proper anesthetic method selection is essential for maintaining hemodynamic stability, minimizing side effects, and promoting early recovery during ENT and general surgical procedures. The purpose of this randomized controlled study was to evaluate total intravenous anesthesia (TIVA) and balanced general anesthesia (BGA) in patients having both otolaryngological (ear, nose, and throat) and general surgical operations. Materials and Methods: 50 adult patients, ages 18 to 60, with physical status I-II according to the American Society of Anesthesiologists (ASA), were enrolled and divided into two groups at random (n = 25 each). Group B underwent TIVA with infusions of propofol and remifentanil, while Group A received balanced general anesthesia with sevoflurane and nitrous gas. Postoperative nausea and vomiting (PONV), recovery duration, intraoperative anesthetic needs, sedation scores, and hemodynamic parameters (heart rate, mean arterial pressure) were also noted. Statistical analysis was performed using Student’s t-test and Chi-square test, with a p-value < 0.05 considered significant. Results: The baseline demographic statistics were similar for both groups. The TIVA group (Group B) had improved intraoperative hemodynamic stability, with less changes in heart rate and mean arterial pressure (p<0.05). Group B had far lower recovery durations (8.4±2.3 min) than Group A (12.6±3.1 min). The TIVA group had a lower rate of nausea and vomiting after surgery (12%) than the inhalational anesthetic group (36%). The sedation scores were similar, and there were no major side effects. Conclusion: Patients receiving combination ENT and general surgical operations benefit more from total intravenous anesthesia with propofol and remifentanil than balanced general anesthesia in terms of intraoperative hemodynamic stability, recovery time, and postoperative nausea and vomiting. Patients' outcomes and recovery times can be improved with this safe and effective alternative to these surgeries.