• J Clin Anesth · Aug 2002

    Randomized Controlled Trial Comparative Study Clinical Trial

    Comparison of total intravenous anesthesia and sevoflurane-fentanyl anesthesia for outpatient otorhinolaryngeal surgery.

    • Félix R Montes, Julio E Trillos, Ismael E Rincón, Juan C Giraldo, José D Rincón, María V Vanegas, and Hernán Charris.
    • Department of Anesthesiology, Fundación Cardio Infantil - Instituto de Cardiología, Universidad del Rosario, Bogotá, Colombia, South America. cfmont@col1.telecom.com.co
    • J Clin Anesth. 2002 Aug 1;14(5):324-8.

    Study ObjectiveTo compare the recovery characteristics of two widely used anesthetic techniques: remifentanyl-propofol and sevoflurane-fentanyl in a standardized ambulatory population.DesignRandomized, single-blinded study.SettingUniversity-affiliated medical center.Patients50 ASA physical status I and II patients undergoing elective ambulatory otorhinolaryngeal surgery.InterventionsPatients were randomized two groups to receive total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-fentanyl (SF group). TIVA patients received induction with propofol 1.5 mg/kg intravenously (IV) and remifentanil 0.5 microg/kg IV. The anesthesia was continued with a continuous infusion of propofol 100 microg/kg/min and remifentanil 0.0625-0.25 microg/kg/min. The SF group received, at induction, fentanyl 2 microg/kg followed by propofol 1.5 mg/kg IV. Maintenance was obtained with 1 to 1.5 minimum alveolar concentration of sevoflurane and bolus of fentanyl 1 microg/kg IV as needed.Measurements And Main ResultsEarly recovery times (eye opening, response to commands, extubation, orientation, operating room stay after surgery, and Aldrete score > or =9) and patient satisfaction were similar between the two groups. Postanesthetic discharge scoring system (PADSS) > or = 9 was significantly shorter for the TIVA group (135.9 +/- 51 vs. 103 +/- 32 min) (p < 0.01) but this difference was not associated with a shorter postanesthesia care unit (PACU) length of stay.ConclusionEarly recovery times are comparable between total intravenous anesthesia and sevoflurane-based anesthesia. Even though patients in the TIVA group achieved home readiness criteria in a significantly shorter time, this technique does not shorten PACU length of stay, which depends instead on multiple nonmedical and administrative issues.

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