[Anesthetic management by continuous total intravenous anesthesia]

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Total intravenous anesthesia (TIVA) is recommended for preventing operating room air pollution.
• Intermittent TIVA can lead to prolonged emergence times, especially with inexperienced practitioners.
• Continuous TIVA strategies are being explored to optimize anesthetic recovery.

Purpose of the Study:

• To compare emergence times between continuous TIVA using propofol, ketamine, and vecuronium combined with butorphanol (PKBt) or buprenorphine (PKBp).
• To evaluate the efficacy of continuous TIVA in reducing anesthetic emergence time.

Main Methods:

• Subjects received induction with propofol, ketamine, vecuronium, and an opioid.
• Maintenance involved continuous intravenous infusions of propofol, ketamine, vecuronium, and either butorphanol or buprenorphine.
• Emergence times were measured from the end of the operation (Op time), end of propofol (Pr time), and end of opioid (B time) to awareness.

Main Results:

• No significant differences in Op, Pr, or B times were observed between the PKBt and PKBp groups.
• Elderly patients, those with longer anesthetic durations, and those receiving combined general and epidural anesthesia exhibited longer B times.
• Op and Pr times showed no significant variations based on patient age, anesthetic duration, or type of anesthesia.

Conclusions:

• Continuous TIVA with PKBt or PKBp is effective in reducing emergence time and preventing air pollution.
• Factors such as patient age, anesthetic duration, and concurrent epidural anesthesia can influence opioid emergence time (B time).
• Continuous TIVA represents a valuable approach for optimizing anesthetic recovery and environmental safety in the operating room.