Haemodynamic changes with Isoflurane and Propofol during Spine Surgery under General Anaesthesia: A Comparative Study

Haemodynamic stability is essential requirements of modern anaesthesia. Usually both propofol and isoflurane meet these criteria though the clinical effects like postoperative nausea and vomiting, after administering propofol and isoflurane have been studied in various operations. Isoflurane has a low blood gas partition coefficient, which contributes to rapid induction and emergence from anaesthesia than with other volatile anaesthetics in current clinical use. Propofol has been established as the intravenous agent that provides faster and smoother recovery and perioperative Haemodynamic stability. In this Randomized controlled trial, patients admitted for spine surgeries under general anaesthesia, at Department of Anaesthesia and ICU and Department of Neuro-Surgery, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh from January 2022 to December 2022. Patients were selected in the pre anaesthesia check up room on the basis of inclusion and exclusion criteria those were scheduled for spine surgeries under General Anaesthesia. They were divided into two groups by randomization; Group P and Group I. A written informed consent was taken from all selected patients. Patients were advised to fast for at least 8 hours before intervention. In the operating room, after preoxygenation with 100.0% O2 for three minutes, patients induced with Injection propofol (1.5 mg/kg) intravenously in both groups, intubation done with Injection succinylcholine (2mg/kg). In Group I, anaesthesia maintain with isoflurane, nitrous oxide (66.0%) and oxygen (33.0%), while in Group P it is maintain with propofol infusion, nitrous oxide (66.0%) and oxygen (33.0%). All patients are given N₂O in oxygen and 1.25% inspired concentration of Isoflurane (MAC -1.15) in Group I, while propofol infusion at rate of 80 μg/kg/min (fixed from the beginning) in Group P. All data collected at -Just after starting, 15 minute, 30 minute, 1 hour and >1 hour interval per operatively. Data was compiled, edited and plotted in tabular and figure form to evaluate the effects of isoflurane and propofol regarding hemodynamic status. Eighty (80) patients yielded the following results. The mean age of Group I and P were 34.6±12.5 years and 32.56±12.55 years. Mean difference of heart rate was lower in Group P than that of Group I. Others parameter in both groups were confined to good and acceptable categories. But interestingly, there was statistically significant difference found between Group P and Group I in SBP and DBP. The scoring was far better in Group P than Group I. Mean SBP was higher in Group I than Group P (p>0.05). Similarly, mean DBP was also higher in Group I than Group P (p>0.05). Propofol is clearly ahead to maintain hemodynamic status than Isoflurane for Spine surgery under General anaesthesia.