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Comparison of surgical field visibility during propofol or desflurane anesthesia for middle ear microsurgery

Xia Yuan1, Tingjie Liu1, Chunbo Hu1

  • 1Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital, Fudan University, 83 fenyang road, Shanghai, 200031, China.

BMC Anesthesiology
|May 25, 2019
PubMed
Abstract

Insights

This study compared propofol/remifentanil (PR) and desflurane/remifentanil (DR) anesthesia for middle ear surgery. While DR offered slightly better surgical field visibility, both anesthesia types provided acceptable conditions with no significant differences in patient recovery.

Area of Science:

  • Anesthesiology
  • Surgical Outcomes
  • Pharmacology

Background:

  • Middle ear microsurgery for cholesteatoma otitis media requires optimal surgical field visibility.
  • Evaluating anesthetic techniques that balance surgical conditions with patient safety is crucial.

Purpose of the Study:

  • To compare surgical field visibility between propofol/remifentanil (PR) and desflurane/remifentanil (DR) anesthesia in patients undergoing middle ear microsurgery.

Main Methods:

  • Eighty adult patients (ASA I-II) were randomized to PR or DR anesthesia.
  • Anesthesia depth was monitored using Bispectral Index (BIS) (40-50).
  • Surgical field visibility was assessed using Boezaart scores.

Main Results:

  • Both PR and DR groups achieved average Boezaart scores below 2, indicating good visibility.
  • Surgical field visibility scores were slightly lower in the PR group compared to the DR group.
  • Remifentanil consumption and its effect-site concentration were significantly higher in the PR group.

Conclusions:

  • While desflurane/remifentanil (DR) anesthesia demonstrated slightly superior surgical field visibility, both anesthetic regimens provided clinically acceptable operative conditions.
  • The propofol/remifentanil (PR) group required significantly more remifentanil.
  • No significant differences were observed in extubation or post-anesthesia care unit times between the groups.
Keywords:
Anesthetics, inhalationAnesthetics, intravenousDesfluraneHypotension, controlledOtolaryngologyPropofolSurgery

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