Adv Clin Exp Med
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Randomized Controlled Trial Comparative Study
Sevoflurane vs. TIVA in terms of middle ear pressure during laparoscopic surgery.
The aim of this study was to investigate the effects of CO2 insufflation on the pressure of the middle ear cavity (PMEC) during laparoscopic surgery under total intravenous anesthesia (TIVA) with propofol or sevoflurane as an inhalational anesthetic maintenance. ⋯ Our results indicate that, in laparoscopic surgery, TIVA used for the maintenance of anesthesia did not increase the PMEC and the changes caused by sevoflurane were also in the normal range of middle ear pressures. In patients with previous ear surgery, if there is a need of classical surgical procedures in the future, sevoflurane anesthesia should not be the first choice due to its effects on PMEC, which cause it to be increased over 50 daPa, especially at 30 min after intubation. Patient characteristics including previous ear surgery should be considered in selecting the optimum anesthetic agents and technique.