Do Anesthetic Techniques Affect Operating Room Efficiency? Comparison of Target-Controlled Infusion of Propofol and Desflurane Anesthesia in Breast Cancer Surgery

Abstract

Background: Anesthetic techniques may contribute to the reduction of operating room (OR) costs by decreasing anesthesia-controlled time. Anesthesia induction and emergence have to be time-optimized without neglecting patient care. The purpose of this study was to compare total intravenous anesthesia (TIVA group) and desflurane anesthesia (desflurane group) with respect to OR efficiency and the incidence of postoperative nausea and vomiting (PONV) in breast cancer surgery. Design: Retrospective clinical study. Methods: Information from the anesthesia database of the Tri-Service General Hospital for January 2010 to December 2011 was retrieved for patients who underwent breast cancer surgery. Three hundred and sixteen patients were included in the TIVA group (n = 196) or the desflurane group (n = 120). Emergence from anesthesia, OR time, and PONV were compared. Results: Emergence time was significantly shorter in the TIVA group than in the desflurane group (4.5±4.6 min vs. 10.4±6.4 min; P ＜ 0.01). There were no significant differences in postanesthesia recovery (PAR) discharge time between the groups. However, the total OR stay time was significantly shorter in the TIVA group than in the desflurane group (167±34 min vs. 173 ± 33 min; P ＜ 0.05). Increased PONV (30.9% vs. 12.2%; P ＜ 0.01) and antiemetic usage (19 vs. 5; P ＜ 0.05) were reported in the desflurane group compared with the TIVA group. Conclusion: TIVA provided faster emergence, increased OR efficiency, and decreased PONV compared with desflurane anesthesia in breast cancer surgery.