Less adrenergic activation during cataract surgery with total intravenous than with local anesthesia.
نویسندگان
چکیده
BACKGROUND Previous studies reported that, contrary to local anesthesia, cataract surgery under inhalational anesthesia is associated with substantial adrenergic activation. We tested the hypothesis that total intravenous anesthesia (TIVA) with propofol and alfentanil produces less or comparable adrenergic activation during cataract surgery than local anesthesia. METHODS Patients were randomly assigned to peribulbar local block (n=10) or TIVA (n=10). The heart rate, blood pressure, plasma concentrations of catecholamines, cortisol, and glucose were assessed at seven pre-, intra-, and post-operative time points. RESULTS In the patients given local anesthesia, plasma concentrations of epinephrine, norepinephrine and cortisol did not change significantly. In contrast, plasma epinephrine decreased by roughly 66% during TIVA: from 45+/-16 to 15+/-8 pg/ml. Plasma norepinephrine concentration decreased by roughly 50%, from 462+/-265 to a minimum value of 219+/-6 pg/ml and plasma cortisol concentrations decreased by roughly 61%, from 16.4 ng/ml to 6.4 ng/ml. Blood pressure and heart rates remained near baseline values during local anesthesia. In contrast, systolic blood pressure decreased by 30% and heart rate by 12 beats/min during TIVA. CONCLUSION The presented study and available data clearly suggest that local anesthesia produces the best adrenergic and hemodynamic stability during cataract surgery. Contrary to previously reported results on inhalational anesthesia (thiopentone/enflurane), the TIVA regimen used effectively prevents the adrenergic and metabolic response during cataract surgery.
منابع مشابه
بررسی اثرات درمانی و عوارض سه روش بیهوشی عمومی و بی حسی موضعی و سطحی در اعمال جراحی کاتاراکت1
Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned t...
متن کاملThe Effect of Inhalation Anesthesia with Hyperventilation and Total Intravenous Anesthesia on Intracranial Pressure Control in Pediatrics with Craniosynostosis Surgery: A Randomized Clinical Trial
Background: Intracranial pressure (ICP) control is one of the anesthesiologist challenges in craniosynostosis repair surgery, especially in multiple sutures involvement. The aim of this study was comparing the effect of two anesthesia methods including inhalation with hyperventilation and total intravenous anesthesia (TIVA) on ICP control and surgeon satisfaction in pediatrics with craniosynost...
متن کاملComparison of the Effects of Midazolam, Propofol, and Dexmede-tomidine on Hemodynamics Variation in Patients Undergoing Cataract Surgery under Local Anesthesia at 5th Azar Hospital in Gorgan in 2021-2022
Introduction: Cataract surgery is a common surgery, especially among the elderly, and the choice of anesthesia medications is critical in such patients. In this study, the effects of midazolam, propofol, and dexmedetomidine were investigated for sedation in patients undergoing cataract surgery under local anesthesia. Method: Ninety patients were included in this study and underwent cataract su...
متن کاملComparison of Total Intravenous Anesthesia (TIVA) with Inhalation Anesthesia in Pediatric Bronchoscopy
Background: Because of airway stimulations during the bronchoscopy and lack of direct access to the airway, preferred method of anesthesia for rigid bronchoscopy is already controversial. In this study we compared inhalation anesthesia with total intravenous anesthesia (TIVA) for rigid bronchoscopy. Method and Materials: 30 patients aged 2-6 years were chosen divided on two same groups. Anesthe...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Acta anaesthesiologica Scandinavica
دوره 44 3 شماره
صفحات -
تاریخ انتشار 2000