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Category: Volume 06 Issue 01 January 2018
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Title: A Prospective Observational Study Comparing total Intravenous Anaesthesia (TIVA) and Inhalational Anaesthesia for Controlled Hypotension in Radical Reconstructive Surgeries of Oral Cancers

Authors: Sudha P, Subha R, Neelima VS

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.86

Abstract

Context:  Controlled hypotension in oromaxillofacial surgeries provides better visualization of surgical field and decreased blood loss. The aim of the study was to know whether TIVA using propofol was superior to inhalational anaesthesia for controlled hypotension

Aims: The aim of the study was to know whether TIVA was superior to inhalational anaesthesia for controlled hypotension

Settings and Design: Prospective observational study for six months in major operation theatre complex of a tertiaty cancer centre.

Methods and Material: 132 ASA physical status I and II adult patients (Inhalational group, n = 66; TIVA group, n = 66) were analysed. Mean arterial blood pressure (MAP) and mean heart rate (HR) at different time intervals, time taken for fall in MAP to the desired level, intra operative blood loss, operative field conditions based on Fromm and Boezaart scale and requirement of supplemental Nitroglycerine(NTG) infusion for MAP control were compared.

Statistical Analysis Used: Comparison of qualitative variables was done using Chi square test and comparison of quantitative variables was done using Student’s t - Test. Result was considered statistically significant when p-value was <0.05.

Results: Significantly more number of patients in the inhalational group required supplemental hypotensive drug (NTG) infusion for controlled hypotension than in the TIVA group (p = 0.000). There was no significant difference between the two groups with regard to time taken for decreasing MAP to 70 mm Hg (p=0.722), total intraoperative blood loss (p=0.215) and surgical field conditions (p=0.803).
Conclusions: Controlled hypotension was obtained in TIVA group with significantly lesser use of supplemental hypotensive drug. Hence TIVA proved to be better than inhalational anaesthesia for controlled hypotension intraoperatively. However, with regard to total intraoperative blood loss & surgical field conditions, both groups were comparable.

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Corresponding Author

Subha R

Assistant Professor, Division of Anaesthesiology, Regional Cancer Centre,

Thiruvananthapuram, Kerala 695011, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., 9446700525