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Comparison of total intravenous anesthesia and sevoflurane-fentanyl anesthesia for outpatient otorhinolaryngeal surgery

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Montes F.R.
Trillos J.E.
Rincón I.E.
Giraldo J.C.
Rincón J.
Vanegas M.V.
Charris H.



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Study Objective: To compare the recovery characteristics of two widely used anesthetic techniques: remifentanyl-propofol and sevoflurane-fentanyl in a standardized ambulatory population. Design: Randomized, single-blinded study. Setting: University-affiliated medical center. Patients: 50 ASA physical status I and II patients undergoing elective ambulatory otorhinolaryngeal surgery. Interventions: Patients were randomized two groups to receive total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-fentanyl (SF group). TIVA patients received induction with propofol 1.5 mg/kg intravenously (IV) and remifentanil 0.5 ?/kg IV. The anesthesia was continued with a continuous infusion of propofol 100 ?g/kg/min and remifentanil 0.0625-0.25 ?g/kg/min. The SF group received, at induction, fentanyl 2 ?g/kg followed by propofol 1.5 mg/kg IV. Maintenance was obtained with 1 to 1.5 minimum alveolar concentration of sevoflurane and bolus of fentanyl 1 ?g/kg IV as needed. Measurements and Main Results: Early recovery times (eye opening, response to commands, extubation, orientation, operating room stay after surgery, and Aldrete score ?9) and patient satisfaction were similar between the two groups. Postanesthetic discharge scoring system (PADSS) ? 9 was significantly shorter for the TIVA group (135.9 ± 51 vs. 103 ± 32 min) (p less than 0.01) but this difference was not associated with a shorter postanesthesia care unit (PACU) length of stay. Conclusion: Early recovery times are comparable between total intravenous anesthesia and sevoflurane-based anesthesia. Even though patients in the TIVA group achieved home readiness criteria in a significantly shorter time, this technique does not shorten PACU length of stay, which depends instead on multiple nonmedical and administrative issues. © 2002 by Elsevier Science Inc.
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Atropine , intravenous , Etilefrine , Fentanyl , sevoflurane , Morphine , Neostigmine , Ondansetron , Propofol , Remifentanil , Sevoflurane , Adolescent , Adult , Aged , Ambulatory surgery , Anesthesia induction , Article , Bradycardia , Clinical article , Clinical trial , Continuous infusion , Controlled clinical trial , Controlled study , Cornea reflex , Dose calculation , Drug infusion , Drug use , Ear nose throat disease , Elective surgery , Extubation , Female , Health status , Human , Hypotension , Intermethod comparison , Intravenous anesthesia , Length of stay , Male , Minimum lung alveolus concentration , Nursing , Orientation , Otorhinolaryngology , Pain , Patient satisfaction , Priority journal , Randomized controlled trial , Scoring system , Single blind procedure , Surgical patient , University hospital , Vomiting , Adolescent , Adult , Ambulatory surgical procedures , Anesthesia recovery period , Anesthesia , Anesthetics , Anesthetics , Female , Fentanyl , Humans , Male , Methyl ethers , Middle aged , Otorhinolaryngologic surgical procedures , Piperidines , Propofol , Prospective studies , Single-blind method , Time factors , Anesthetics , Opioids , Ambulatory Surgery
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