[Do short-term duration drugs for anaesthesia give postoperative advantages compared to traditional drugs?].
Publication/Presentation Date
9-11-2003
Abstract
BACKGROUND: We wanted to compare totally intravenous anaesthesia with propofol and remifentanil to mixed anaesthesia with isoflurane and fentanyl in terms of postoperative pain, nausea, length of stay and costs.
MATERIAL AND METHODS: We present a prospective, non-randomised, anaesthetist-based double-blind study with a cost-utility analysis on consecutive patients undergoing laparoscopic gynaecologic day-care surgery. Premedication consisted of paracetamol and diclofenac. The mixed anaesthesia group received propofol, isoflurane, fentanyl, vecuronium, N2O and O2,the total intravenous group propofol, remifentanil, vecuronium, N2O and O2. Paracetamol and ketobemidon, metoklopramid and ondansetron were given to relieve pain and nausea, respectively. Patients were asked to report pain and nausea on a visual analogue scale after 4 and 24 hours.
RESULTS: 26 mixed and 27 totally intravenous patients were comparable by age, body mass index and ASA (American Society of Anesthesiologists) scores. There was a protocol violation, as fewer totally intravenous patients received pre-medication (16/26 vs. 8/27 p < 0.001). Totally intravenous patients had significantly higher consumption of ketobemidon (mean 2.35 vs. 5.43 mg/24 h p < 0.004). Within the totally intravenous group, scores for pain at 24 hours were significantly higher as compared with 4-hour scores (p = 0.012). At 24 hours, scores for nausea were significantly higher for the totally intravenous group (1.87 vs. 3.21 p = 0.014). Length of stay did not differ significantly (mean 649 vs. 729 min p > 0.2). Costs of medication were significantly higher for the totally intravenous group (mean 211 vs 285 NOK p <0.001).
INTERPRETATION: The use of totally intravenous anaesthesia led to more nausea and more expenses than mixed anaesthesia in laparoscopic gynaecologic day-care surgery. No recommendations for either method can be made because of the non-randomized design.
Volume
123
Issue
17
First Page
2445
Last Page
2447
ISSN
0807-7096
Published In/Presented At
Laberg, G. O., Leirvåg, J. P., Leeuwenberg, J., & Bergamaschi, R. (2003). Har totalintravenøs anestesi fordeler i den postoperative fase fremfor blandingsanestesi? [Do short-term duration drugs for anaesthesia give postoperative advantages compared to traditional drugs?]. Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 123(17), 2445–2447.
Disciplines
Medicine and Health Sciences
PubMedID
14562776
Department(s)
Department of Surgery
Document Type
Article