Comparison of inhalation and total intravenous anaesthesia for laparoscopic cholecystectomy

Abstract

The aim of this study is to investigate the effects of inhalation anaesthesia (with isoflurane) and total intravenous anaesthesia (TIVA) (with propofol) on heart rate, arterial pressure and oxygen saturation in laparoscopic cholecystectomy. Fourty ASA I-II-III patients aged 23 to 80 years were included in this study. The patients were divided randomly into two equal groups. Inhalation anaesthesia group received 66% N20 + 33% O2 + 1-1.5% isoflurane and the TIVA group received propofol infusion respectively at the first 15 min 10 mg/kg/h, at the next 15 min 8 mg/kg/h; then until 10 min before the end of the operation 6 mg/kg/h. Heart rates, arterial pressures and oxygen saturations were measured at the beginning, after induction, intubation, insufflation, positioning, exsufflation and return to the horizontal position; intraoperatively and at the end of the anaesthesia at 5th, 15th, 30th, 45th and 60th minutes. The cardiac rhythm recorded by ECG. There were no statistically significant differences between two groups in heart rate, arterial pressures and cardiac rhythm (p>0.05). In inhalation group at the 5th minutes of operation systolic arterial pressures increased with respect to the time after the insufflation (p<0.05). Significant decreases seen in mean arterial pressure at the 15th minutes with respect to 30th, 45th and 60th minutes of the recovery (p<0.05) and in diastolic arterial pressures at the 5th minutes with respect to 15th, 30th and 45th minutes of the recovery (p<0.05). In TIVA group oxygen saturation values were higher than inhalation group (p<0.01). In cardiac rhythm no differences were found between two groups. We concluded that TIVA would be preferable than inhalation anesthesia because of its stability hemodynamic aspects but both methods could be used safely in laparoscopic cholecystectomy.