Online ISSN: 2515-8260

COMPARISON OF INTRAOPERATIVE HAEMODYNAMIC PARAMETERS AND COST EFFECTIVENESS BETWEEN SEVOFLURANE (INHALATIONAL) ANAESTHESIA AND PROPOFOL (TIVA) BASED ANAESTHESIA

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Dr. Vinita Rawat

Abstract

Introduction: Loss of blood in any type of surgery caused by many reasons. It is not only due to surgical procedures or anaesthesia related methods. It can be reduced due to various methods out of which maintaining hypotension is most common. For this purpose, combination of nitroprusside or esmolol drips and various other anaesthetic drugs can be used. Aims and Objectives: The present prospective and comparative study was conducted to compare the intraoperative haemodynamic parameters and cost effectiveness between sevoflurane (inhalational) anaesthesia and propofol (TIVA) based anaesthesia. Material and Methods: Present prospective comparative study was carried out in the Department of Anaesthesiology and Critical Care, World College of Medical Sciences & Research Hospital Girawar, Jhajjar, Haryana (India). A total of 40 patients were included who were further divided into two groups of 20 each with age range of 20-60 years. Patients were graded according to ASA I-II. Results: Mean age of the patients in group S was 38.11±9.28 and in group P, it was 41.27±10.12 years. A total of 16 patients were male and 4 were female in group S. Similarly, in group P, we found 18 male and 2 female. Mean body mass index in group A was 23.25±4.18 and in group P, it was 26.32±8.18 (kg/m2). A total of 14 patients in group S and 16 in group P had ASA grade I. Similarly, ASA grade II was observed in 6 patients of group S and 4 patients of group P (p >0.05). Mean induction time was 53.25±6.75 in group S and 62.21±9.19 seconds in group P (p <0.001). MAP at baseline was 101.5±4.18 in group S which decreased to 98.2±5.87 before induction and thereafter to 91.4±4.54 after induction. After 1 minute of induction it was 93.2±3.28, after 5 minute 98.2±4.87, at 10 minutes 99.4±5.28, 20 minutes 99.9±6.28, 30 minutes 102.2±4.28, at 40 minutes 103.4±3.18, after 50 minutes 104.2±4.28 and finally after 60 minutes it was 103.2±3.28. Similarly, in group P, mean arterial pressure was higher at baseline. It was 104.7±5.98, decreased to 97.9±6.58 before induction and thereafter to 87.2±4.92 after induction. After 1 minute of induction it was 90.2±3.92, after 5 minute 96.1±292, at 10 minutes 93.1±2.94, 20 minutes 94.1±4.92, 30 minutes 99.1±3.12, at 40 minutes 98.1±5.92, after 50 minutes 97.4±5.92 and finally after 60 minutes it was 99.1±6.92. Eye opening mean values was 10.5±2.3, verbal communication 12.4±2.2 and mental orientation was 17.4±1.9 in group A. In group P, it was 14.2±2.8, 15.6±3.2 and 22.2±3.2, respectively (p <0.001 Significant). Mean cost of anaesthesia in group S was 412.25±95.14 Indian rupees (INR) and in group P, it was higher i.e. 504.85±101.20. Total cost including wastage was 625±104.24 in group S and higher in group P i.e. 750.84±212.45. Conclusion: We concluded that cost of sevoflurane is less as compared to propofol. We further found that haemodynamic effects of both is comparable.

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