Recovery after laparoscopic anesthesia: Three different anaesthesia techniques: Recovery after laparoscopic anesthesia

Abstract

A laparoscopic approach is commonly used for cholecystectomy today. Overall morbidity and mortality after this type of surgery depends on both surgical and anesthetic procedures, primarily from the choice of anesthesia technique and drugs throughout the entire perioperative period. It is very important to choose the anesthesia technique that has the best recovery profile. The aim of this prospective study is to determine which type of anesthesia enables the fastest recovery of patients after laparoscopic cholecystectomy. Methods: This prospective longitudinal study examined the recovery profile of three different anesthetic techniques: volatile induction and maintenance of anaesthesia with sevoflurane, low-fresh gas flow anesthesia with sevoflurane with target-controlled infusion of sufentanil, and total intravenous anesthesia with propofol and sufentanil. Ninety patients were randomized into three groups based on three anesthesia techniques. The degree of recovery was measured in minutes, including the time from the stopping of anesthetic agents to the start of spontaneous ventilation, time to adequate response to the verbal command, time of extubation, time to adequate orientation of the patient and, finally, the discharge time from the operating block. Result: According to the measured parameters, the best recovery profile was found in patients with low-flowed fresh gas of sevoflurane and target-controlled infusion of sufentanil. Slightly worse but satisfactory recovery profile was detacted in patients with total intravenous ropofol and sufentanil anesthesia. The worst recovery profile was found in the group of patients with sevoflurane induction and maintenance of anesthesia. Conclusion: Among three selected anesthesia techniques for laparoscopic cholecystectomy low-flow sevoflurane anesthesia with target-controlled infusion of sufentanil and total intravenous anesthesia take precedence over the sevofluarane induction and maintenance anesthesia.

Keywords

• anesthesia
• abdominal surgery
• recovery