Desflurane versus total intravenous anesthesia in improving the postoperative outcome for the patient undergoing spinal fixation

Abstract

Background Total intravenous anesthesia (TIVA) and volatile inhalation anesthesia are both standardized techniques for lumbar laminectomy and discectomy procedures. Objective To compare TIVA versus desflurane anesthesia in improving postoperative recovery for patients undergoing spinal fixation. Patients and methods This prospective, double-blind, randomized study was carried out on 60 patients undergoing spinal fixation. Patients were randomized into two equal groups: group D received desflurane anesthesia, and group T received TIVA technique. Induction was done by propofol, fentanyl, and rocuronium. Anesthesia was maintained using desflurane in oxygen air mixture in group D. Still, anesthesia was maintained by intravenous infusion of propofol and dexmedetomidine in group T. Intraoperative vital signs, recovery time, postoperative nausea and vomiting, visual analog score, postanesthetic care unit stay time, total first 24 h postoperative analgesic needs, and serum cortisol and interleukin 6 preoperative and postoperative were assessed. Results TIVA group had lower intraoperative heart rates and mean arterial blood pressure. TIVA group also had a faster recovery time, shorter postanesthetic care unit stays, lower postoperative visual analog score for pain assessment, lower total analgesic requirements, and lower incidence of nausea and vomiting. Conclusions TIVA provided better postoperative recovery with fewer postoperative adverse effects and analgesia need.