Talih G, Yüksek A, Şahin E. Evaluation of emergence agitation after general anaesthesia in rhinoplasty patients: Inhalation anaesthesia versus total intravenous anaesthesia.
Am J Otolaryngol 2020;
41:102387. [PMID:
31926597 DOI:
10.1016/j.amjoto.2020.102387]
[Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Emergence agitation (EA) is a clinical condition that occurs early in recovery from general anaesthesia, and reduces patient comfort. The aim of this study was to compare the effects of low-flow sevoflurane anaesthesia and total intravenous anaesthesia (TIVA) on agitation in rhinoplasty patients, and to determine the frequency of EA in low flow sevoflurane anaesthesia after rhinoplasty.
MATERIAL AND METHODS
A total of 90 rhinoplasty patients, under general anaesthesia were included in this prospective randomised study. After induction of anaesthesia, propofol infusion was initiated in the TIVA group (n = 45), and sevoflurane was administered in the SEVO group with a fresh gas flow of 1 l/min and MAC (minimum alveolar concentration) 1-1.1 (n = 45). Early emergence times, Richmond agitation-sedation scale (RASS), Boezaart scale, Likert scale and incidences of nausea/vomiting were recorded at the end of surgery.
RESULTS
Early emergence time was significantly shorter in the TIVA group, than in the SEVO group (p < 0.001). İntraoperative bleeding was significantly lower in the TIVA group, than in the SEVO group (p = 0.005), and surgical field image quality and surgeon satisfaction were better in the TIVA group (p = 0.016, p < 0.001). The ratio of patients with RASS > +1 for all patients was 35.6% at 0 min, postoperatively. This rate was 12.2% (n = 11) in the TIVA group, and 23.3% (n = 21) in the SEVO group (p = 0.028).
CONCLUSIONS
In rhinoplasty, TIVA caused shorter early emergence times, less bleeding, high surgeon satisfaction, and lower EA scores when compared with low flow sevoflurane anaesthesia.
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