Comparison of inhalational (VIMA) and intravenous (TIVA) anaesthesia in gynaecological procedures
European Journal of Anaesthesiology:
Abstracts and Programme: European Society of Anaesthesiologists; 9th Annual Meeting with the Swedish Society of Anaesthesiology; Gothenburg, Sweden, 7-10 April 2001: Evidence Based Medicine, Quality Insurance and Safety
Center of Anaesthesiology, J.W. Goethe-University, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany
Background and goal of the study: General anaesthesia can be achieved by administration of a volatile anaesthetic alone (VIMA = volatile induction and maintenance of anaesthesia) or by a total intravenous technique (TIVA) . Our study compared both techniques during induction and emergence from anaesthesia.
Materials and methods: After ethics committee approval, 142 ASA I-II patients received randomly either VIMA (n = 70) or TIVA (n = 72). Induction in the VIMA group was achieved by inhalation of a mixture of 8% sevoflurane, 50 Vol% N2O and 42 Vol% O2. Anaesthesia was maintained with 2-3 MAC sevoflurane, 66 Vol% N2O and 31% O2. TIVA consisted of remifentanil (Induction: 0.3 μg kg−1 min−1, maintenance: 0.1-0.3 μg kg−1 min−1) and propofol (induction: 4 μg mL−1, maintenance: 2.5-3.5 μg mL−1). Adjustment of anaesthetic depth was guided clinically. We determined time required for induction and emergence and observed side-effects.
Results and discussion: Demographic data and operative times were comparable; however, there was a significant difference with regard to incidence of PONV and shivering. TABLE
Conclusions: Both techniques are suitable for gynaecological procedures. However, due to a lower incidence of PONV and shivering during the immediate postanaesthesia period, TIVA is superior to VIMA.
1 Jellish WS, Lien CA, Fontenot HJ, Hall R. Anaesth Analg
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