Volume : 7, Issue : 8, August - 2018

Prospective Comparative Analysis for Gynaecology Laparoscopic Surgery between Propofol and Thiopental sodium - Halothane Anaesthesia with respect to haemodynamics, recovery profile and side - effect including Post-operative Nausea, Vomiting & Pain.

Dr. Archana S. Mhatre, Dr. Sunanda Panigrahi

Abstract :

<p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%"><span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp; </span>Laparoscopic surgeries are gaining fame in today&rsquo;s world of ambulatory anaesthesia due to reduced hospital stay and quicker recovery. The present study is prospective comparative study of haemodynamic, recovery profile and side effects including PONV and pain relief using two different anaesthetic techniques: Propofol &amp; Thiopentone &ndash; Halothane anaesthesia.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%"><span style="mso-spacerun:yes">&nbsp;</span>A convenient sample size of 60 patients undergoing elective gynaecology laparoscopic surgeries under General Anaesthesia were enrolled in this study. The inclusion and exclusion criteria were strictly adhered to and the method of anaesthesia was thoroughly standardised. All patients were premedicated with intravenous Midazolam &amp; Pentazocine, received prophylactic antiemetic in the form of intravenous ondansetron. Intravenous propofol (2 mg/kg) was given for induction and maintenance of anaesthesia was with propofol (6 </span><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:Calii;&#10;mso-bidi-theme-font:minor-latin">m</span><span lang="EN-IN" style="font-size:&#10;12.0pt;line-height:107%">g/kg/hr) in Group P. Intravenous thiopentone (4-6 mg/kg) was used for induction and maintenance was with halothane (0.5 &ndash; 2%) in group H along with oxygen and nitrous oxide (40:60) in both the groups.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%">Monitoring included heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) at different time intervals along with special assessment of recovery characteristics were studied. PONV &amp; pain were studied using emesis score &amp; subjective pain score upto 24 hours. All the results were statistically analysed by using Chi &ndash; square test for qualitative data and unpaired student&rsquo;s &lsquo;t&rsquo; test between two groups and paired &lsquo;t&rsquo; test in same group for quantitative data significance assured was at P &lt; 0.05.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%">Haemodynamically, increase in HR, SBP, DBP &amp; MAP in pre to post pneumoperitoneum period for found to be more in Group P than in Group H and all these parameters return to near baseline values post-desufflation. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%">Recovery with respect to spontaneous respiration, Extubation, eye opening to commands and orientation was found to be faster in Group P than in Group H. Anaesthesia using propofol was associated with significantly less PONV than in inhalational technique with halothane after thiopentone induction. With respect to pain there was no difference between the two groups.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:107%">Based on the results, we concluded that anaesthesia with propofol is more suitable for gynaecological laparoscopic surgeries, its major advantage being significantly shorter time of emergence and recovery with less incidence of PONV.<o:p></o:p></span></p>