Effect on thermoregulatory responses in patients undergoing a tympanoplasty in accordance to the anesthetic techniques during PEEP: a comparison between inhalation anesthesia with desflurane and TIVA.
10.4097/kjae.2014.67.1.32
- Author:
Ki Tae JUNG
1
;
Sang Hun KIM
;
Hyun Young LEE
;
Jong Dal JUNG
;
Byung Sik YU
;
Kyung Joon LIM
;
Keum Young SO
;
Ju Young LEE
;
Tae Hun AN
Author Information
1. Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea. than@chosun.ac.kr
- Publication Type:Original Article
- Keywords:
Desflurane;
Inhalation anesthesia;
Intravenous anesthesia;
Positive end expiratory pressure;
Thermoregulation;
Vasoconstriction
- MeSH:
Anesthesia;
Anesthesia, General;
Anesthesia, Inhalation*;
Anesthesia, Intravenous;
Body Temperature Regulation;
Forearm;
Humans;
Inhalation;
Positive-Pressure Respiration;
Pressoreceptors;
Propofol;
Skin Temperature;
Tympanoplasty*;
Vasoconstriction
- From:Korean Journal of Anesthesiology
2014;67(1):32-37
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: It has been known that positive end-expiratory pressure (PEEP) increases the vasoconstriction threshold by baroreceptor unloading. We compared the effect on the thermoregulatory responses according to anesthetic techniques between an inhalation anesthesia with desflurane and a total intravenous anesthesia (TIVA) with propofol and reminfentanil when PEEP was applied in patients undergoing tympanoplasty. METHODS: Forty-six patients with a scheduled tympanoplasty were enrolled and the patients were divided in two study groups. Desflurane was used as an inhalation anesthetic in group 1 (n = 22), while TIVA with propofol and remifentanil was used in group 2 (n = 24). PEEP was applied by 5 cmH2O in both groups and an ambient temperature was maintained at 22-24degrees C during surgery. The core temperature and the difference of skin temperature between forearm and fingertip were monitored for about 180 minutes before and after the induction of general anesthesia. RESULTS: The final core temperature was significantly higher in group 2 (35.4 +/- 0.7degrees C) than in group 1 (34.9 +/- 0.5degrees C). Peripheral thermoregulatory vasoconstriction was found in 5 subjects (23%) in group 1 and in 21 subjects (88%) in group 2. The time taken for reaching the thermoregulatory vasoconstriction threshold was 151.4 +/- 19.7 minutes in group 1 and 88.9 +/- 14.4 minutes in group 2. CONCLUSIONS: When PEEP will be applied, anesthesia with TIVA may have more advantages in core temperature preservation than an inhalation anesthesia with desflurane.
