Key Points: 1. Objective: o To compare the effects of Total Intravenous Anesthesia (TIVA) and sevoflurane anesthesia on respiratory mechanics, hemodynamic parameters, and neuromonitoring during prone position spinal surgeries. 2. Methodology: * A randomized controlled trial involving 52 patients scheduled for lumbar spine surgery, randomly assigned to either TIVA or sevoflurane groups. * Respiratory and hemodynamic parameters were measured at various time points. 3. Results: * No significant differences were found between the TIVA and sevoflurane groups in terms of respiratory mechanics or hemodynamic stability. * Both anesthesia techniques maintained stable intraoperative conditions. 4. Clinical Implications: * Anesthesiologists can flexibly choose between TIVA and sevoflurane based on patient-specific factors and surgical requirements. * TIVA may be preferred in surgeries with high neurological risk due to its compatibility with neuromonitoring. 5. Future Research: * Studies with broader patient populations and long-term outcomes are needed to further refine anesthesia management strategies. * Research on the environmental impact and cost-effectiveness of anesthesia techniques is also important.
This study aims to evaluate the impact of total intravenous anesthesia (TIVA) versus sevoflurane anesthesia on respiratory mechanics and hemodynamic parameters during spinal surgery performed in the prone position. Anesthesia management for spinal surgeries in the prone position is particularly challenging due to significant physiological changes. Identifying the effects of different anesthesia techniques is essential to enhance patient outcomes and ensure intraoperative stability. This randomized controlled trial involved 52 patients scheduled for lumbar spine surgery under general anesthesia. Participants were randomly allocated to either the TIVA group (n=26) or the sevoflurane group (n=26). Measurements of respiratory mechanics, including peak airway pressure (Ppeak), mean airway pressure (Pmean), positive end-expiratory pressure (PEEP), end-tidal CO2 (ETCO2), tidal volume (VT), respiratory rate (RR), and minute ventilation (MV), were taken at various intervals. Hemodynamic parameters such as systolic and diastolic blood pressures and heart rate were continuously monitored.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
DOUBLE
Enrollment
52
Sevoflurane was managed for maintenance of the general anestesia during spinal surgeries
TIVA was managed for maintenance of the general anesthesia during spinal surgeries
Saglik Bilimleri Universitesi
Istanbul, Turkey (Türkiye)
PEEP
positive end-expiratory pressure
Time frame: 5, 15, and 30 minutes after positioning in the prone position
ETCO2
end-tidal carbon dioxide
Time frame: 5, 15, and 30 minutes after positioning in the prone position
VT
tidal volume
Time frame: 5, 15, and 30 minutes after positioning in the prone position
Ppeak
peak airway pressure
Time frame: 5, 15, and 30 minutes after positioning in the prone position
Pmean
mean airway pressure
Time frame: 5, 15, and 30 minutes after positioning in the prone position
RR
Respiratory Rate
Time frame: 5, 15, and 30 minutes after positioning in the prone position
MV
Minute volume
Time frame: 5, 15, and 30 minutes after positioning in the prone position
Cdyn
Dynamic. compliance
Time frame: in the supine position after intubation and in the prone position at the 30th minute
PaO2/FiO2
Partial Oxygen pressure/traction of inspired oxygen
Time frame: in the prone position at the 30th minute
Vd/Vt
dead space/tidal volume
Time frame: in the prone position at the 30th minute
HR
Heart Rate
Time frame: 5, 15, and 30 minutes after positioning in the prone position
SBP
Systolic Blood Pressure
Time frame: 5, 15, and 30 minutes after positioning in the prone position
DBP
Diastolic BloodPressure
Time frame: 5, 15, and 30 minutes after positioning in the prone position
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