Comparison of the Effects of Anesthesia with Isoflurane and Total Intravenous Anesthesia on the Intensity of Body Temperature Reduction during Anesthesia and Incidence of Postoperative Chills
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Abstract
This study compared the effects of anesthesia with isoflurane and TIVA (total intravenous anesthesia) on the intensity of body temperature reduction during anesthesia and incidence of chills after lumbar disc surgery. The study was done as a single blinded randomized clinical trial. From 60 patients who underwent lumbar disc surgery, 30 subjects were placed in isoflurane group and 30 in the TIVA group. Maintenance of anesthesia was done with isoflurane (MAC=0.8-1) and N2O 50% in isoflurane group and in TIVA group with propofol at the dose of 100-150 mg /kg body weight /minute and remifentanil at the dose of 2.0 mg /kg body weight/minute. Chills rate was recorded in recovery room. Changes in body temperature, body surface temperature, systolic blood pressure, diastolic blood pressure and heart rate showed no significant difference between the two groups before and after induction and at different times during the operation (P<0.05). Chill rate was not significantly different between the two groups (P<0.05). It seems that TIVA (remifentanil at the dose of 2.0 µg/kg body weight/minute in combination with propofol at the dose of 100-150 µg/kg body weight/minute) and 0.81 MAC isoflurane–N2O 50% can be used as a safe method of anesthesia in patients with good tolerance lumbar back disc surgery without hypothermia, chills and considerable hemodynamic changes.
Goldberg MJ, Roe CF. Temperature changes during anesthesia and operations. Arch Surg 1966;93(2):365-9.
Bhattacharya PK, Bhattacharya L, Jain RK, Agrarwal RC. Post anaesthesia shivering (PAS): A review. Indian J Anaesth 2003;47(2):88-93.
Sessler DI. Perioperative thermoregulation and heat balance. Ann N Y Acad Sci 1997;813:757-77.
Flores-Maldonado A, Guzmán-Llanez Y, Castañeda-Zarate S, Pech-Colli J, Alvarez-Nemegyei J, Cervera-Saenz M, et al. Risk factors for mild intraoperative hypothermia. Arch Med Res 1997;28(4):587-90.
Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334(19):1209-15.
Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, Beattie C. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA 1997;277(14):1127-34.
Frank SM, Higgins MS, Breslow MJ, Fleisher LA, Gorman RB, Sitzmann JV, Raff H, Beattle Ch. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia. A randomized clinical trial. Anesthesiology 1995;82(1):83-93.
Kurz A, Sessler DI, Narzt E, Bekar A, Lenhardt R, Huemer G, Lackner F. Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia. J Clin Anesth 1995;7(5):359-66.
Bennett RC. Comparison of TIVA and Inhalation Aesthesia in Practice. Proceedings of the 49th Congress of British Small Animal Veterinary Association (BSAVA). UK: Birmingham, 2006.
Pablo LS. Total IV Anesthesia in Small Animals. Proceedings of the 28th Congress of the World Small Animal Veterinary Association (WSAVA). Bangkok: Thailand, 2003.
Nolan A. Total Intravenous Anesthesia in Dogs. Proceedings of the 29th Congress of the World Small Animal Veterinary Association (WSAVA). Greece: Rhodes, 2004.
Kazemi D, Mehrbani YA, Amoghli Tabrizi B. Effects of Total Intravenous Propofol Anesthesia on Canine Hematologic and Coagulative Parameters. Proceedings of the 49th Congress of British Small Animal Veterinary Association (BSAVA). UK: Birmingham, 2006.
Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, Cheng C. Heat flow and distribution during induction of general anesthesia. Anesthesiology 1995;82(3):662-73.
Kurz A, Sessler DI, Christensen R, Dechert M. Heat balance and distribution during the core-temperature plateau in anesthetized humans. Anesthesiology 1995;83(3):491-9.
Støen R, Sessler DI. The thermoregulatory threshold is inversely proportional to isoflurane concentration. Anesthesiology 1990;72(5):822-7.
Ozkose Z, Ercan B, Unal Y, Yardim S, Kaymaz M, Dogulu F, Pasaoglu A. Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. J Neurosurg Anesthesiol 2001;13(4):296-302.
Philip BK, Scuderi PE, Chung F, Conahan TJ, Maurer W, Angel JJ, Kallar SK, Skinner EP, Jamerson BD. Remifentanil compared with alfentanil for ambulatory surgery using total intravenous anesthesia. The Remifentanil/Alfentanil Outpatient TIVA Group. Anesth Analg 1997;84(3):515-21.
Grundmann U, Risch A, Kleinschmidt S, Klatt R, Larsen R. Remifentanil-propofol anesthesia in vertebral disc operations: a comparison with desflurane-N2O inhalation anesthesia. Effect on hemodynamics and recovery. Anaesthesist 1998;47(2):102-10.
Grundmann U, Silomon M, Bach F, Becker S, Bauer M, Larsen B, Kleinschmidt S. Recovery profile and side effects of remifentanil-based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2001;45(3):320-6.
Ozkose Z, Yalcin Cok O, Tuncer B, Tufekcioglu S, Yardim S. Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anesthesia (TIVA). J Clin Anesth 2002;14(3):161-8.
Frank SM, Beattie C, Christopherson R, Norris EJ, Perler BA, Williams GM, Gottlieb SO. Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology 1993;78(3):468-76.
Atarashi K, Ozaki M, Suzuki H. Sevoflurane comparably decreases the threshold for thermoregulatory vasoconstriction as isoflurane. Masui 1996;45(7):818-23.
Ozaki M, Sessler DI, Suzuki H, Ozaki K, Tsunoda C, Atarashi K. Nitrous oxide decreases the threshold for vasoconstriction less than sevoflurane or isoflurane. Anesth Analg 1995;80(6):1212-6.
Smith D, Wood M, Pearson J, Mehta RL, Carli F. Effects of enflurane and isoflurane in air-oxygen on changes in thermal balance during and after surgery. Br J Anaesth 1990;65(6):754-9.
Grundmann U, Risch A, Kleinschmidt S, Klatt R, Larsen R. Remifentanil-propofol anesthesia in vertebral disc operations: a comparison with desflurane-N2O inhalation anesthesia. Effect on hemodynamics and recovery. Anaesthesist 1998;47(2):102-10.
Cartwright DP, Kvalsvik O, Cassuto J, Jansen JP, Wall C, Remy B, Knape JT, Noronha D, Upadhyaya BK. A randomized, blind comparison of remifentanil and alfentanil during anesthesia for outpatient surgery. Anesth Analg 1997;85(5):1014-9.
Uchida K, Hayashida M, Kawate R, Arita H, Hanaoka K. Body temperature changes during combined inhalational and epidural anesthesia. Masui 1998;47(9):1073-9.
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| Issue | Vol 49, No 7 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| Total intravenous anesthesia Isoflurane Chills Body temperature | ||
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