Changes in Lung Function Parameters after Total Intravenous Anaesthesia and Balanced Anaesthesia with Desflurane: A Prospective Randomised Study

Özet

Objective: Following anaesthesia, there is a decrease in pulmonary function. Unlike volatile anaesthetics, propofol decreases the upper airway tone, and total intravenous anaesthesia (TIVA) with propofol may decrease coughing on emergence. Coughing may reduce postoperativeatelectasis. Thus, TIVA may lead to greater decreases in lung function postoperatively as compared to balanced anaesthesia with desflurane.Methods: Sixty patients of either sex, aged 18-60 years and American Society of Anaesthesiologists (ASA) status I/II, who were to undergomastoid surgery, were randomly allocated to Group B and Group T. Anaesthesia was maintained with desflurane, nitrous oxide and oxygenin Group B, and with TIVA in Group T. Pulmonary function tests (PFT) were done preoperatively, and 1, 3 and 24 hours postoperatively.Results: Demographic data and preoperative PFT were comparable in both groups. One hour after surgery, there was a greater decreasein FEV1 and peak expiratory flow rate (PEFR) in Group T (p=0.044 and 0.042, respectively). Three hours postoperatively, the decrease inMEFR and PEFR was again greater in Group T (p=0.005 and 0.008, respectively), while the MEFR recovered to preoperative values inGroup B. By 24 hours, the forced vital capacity (FVC), MEFR and PEFR recovered to preoperative values in Group T, while FVC remainedreduced in Group B (p=0.006).Conclusion: Both anaesthetic techniques cause a postoperative impairment in the lung function, but while TIVA causes a greater reductionin PFT in the early postoperative period, recovery is also earlier. On the other hand, balanced anaesthesia with desflurane was associatedwith a greater reduction in PFT at 24 hours.