Changes in Lung Function Parameters after Total Intravenous Anaesthesia and Balanced Anaesthesia with Desflurane: A...

Area of Science:

• Anesthesiology
• Pulmonary Medicine
• Surgical Outcomes

Background:

• Anesthesia can decrease pulmonary function post-operatively.
• Propofol, unlike volatile anesthetics, reduces upper airway tone, potentially decreasing emergence coughing.
• Reduced coughing may lead to increased postoperative atelectasis, possibly worsening lung function decline with TIVA.

Purpose of the Study:

• To compare the effects of total intravenous anesthesia (TIVA) with propofol versus balanced anesthesia with desflurane on postoperative pulmonary function.
• To evaluate the impact of anesthetic technique on lung function recovery after mastoid surgery.

Main Methods:

• Sixty patients (ASA I/II, aged 18-60) undergoing mastoid surgery were randomized into two groups.
• Group B received desflurane, nitrous oxide, and oxygen; Group T received TIVA with propofol.
• Pulmonary function tests (PFTs) were performed preoperatively and at 1, 3, and 24 hours postoperatively.

Main Results:

• Early postoperative (1 and 3 hours) decreases in FEV1, PEFR, and MEFR were significantly greater in the TIVA group.
• MEFR recovered to preoperative levels by 3 hours in the desflurane group.
• By 24 hours, PFTs (FVC, MEFR, PEFR) recovered to baseline in the TIVA group, while FVC remained reduced in the desflurane group.

Conclusions:

• Both anesthetic techniques impair postoperative lung function.
• TIVA with propofol leads to a more pronounced early reduction in PFTs but allows for quicker recovery.
• Balanced anesthesia with desflurane was associated with greater PFT reduction at the 24-hour mark.