The comparison of the effects of TIVA and inhalation anaesthesia on hemodynamic conditions, metabolic-endocrin responses to trauma and muscle relaxant consumption

Abstract

The aim of this study was to compare the effects of TIVA and inhalational anaesthesia on haemodynamic parameters, metabolic and endocrin responses and muscle-relaxant consumption. 60 female patients, ASA I-II, ages between 30-60, undergoing total abdominal hysterectomy were randomly divided into three groups. For the induction of anaesthesia; propofol 2 mg/kg in Group I, midazolam 0.3 mg/kg in Group II and thiopenthone 7 mg/kg in Group III were administered intravenously. In addition, IV alfentanil 25 ?g/kg was given in Group I and II at induction of anaesthesia. Endotracheal intubation was facilitated with 0.1 mg/kg vecuronium in all groups. Anaesthesia was maintained with propofol 9 mg/kg/h for the first 30 minutes and then 4.5 mg/kg/h for the rest of the operation in Group I, midazolam 0.125 mg/kg/h in Group II and isoflurane 0.8-1.5 % in Group III. Group I and II were also received alfentanil 25 ?g/kg/h . In all groups 67 % N2O in oxygen were given. For muscle relaxation 0.03 mg/kg vecuronium was given when the TOF ratio increased to 20 %. Heart rate (HR), mean arterial pressure (MAP), plasma glucose and cortisol levels, and muscle relaxant consumption were noted. HR, MAP, plasma glucose and cortisol levels were higher in Group III than the other groups (p<O.05). Muscle relaxant consumption was lowest in Group II (p<0.05). In conclusion, TİVA have more advantages for haemodynamic stability according to tradational inhalation anaesthesia. Midazolam decreases musclerelaxant consumption.