Role of propofol with total intravenous anesthesia in intra-abdominal surgeries: A prospective study

Abstract

Background: Postoperative pain can be severe post multiple abdominal surgeries due to the upper abdominal incision and pain management can be difficult for this group of patients, therefore total intravenous anaesthesia is a technique involving infusion and maintenance of anaesthetic state with intravenous drugs alone. But no agent has all the characteristics of ideal TIVA agent. Propofol has three important characteristics of ideal TIVA agent, i.e. rapid induction, rapid metabolism and rapid recovery. In this communication we studied the characteristics of propofol in total intravenous anaesthesia in various intra-abdominal surgeries. Methods: Here our sample size was 52 patients aged 18 to 60 years belonging to ASA gr 1 and gr 11 undergoing various elective intra- abdominal surgery took part in this prospective study. All patients were induced with 2mg/kg body weight 1% propofol after premedication 0.03 mg midazolam and pentazocine. Anesthesia maintained with 0.1% propofol at rate of 100Ug/kg/min with 100% oxygen and incremental dose muscle relaxant. Based on haemodynamic sings and sympathetic over activity dose of propofol was adjusted in intraoperative period. At skin closure infusion was discontinued and neuromuscular blockade reversed. Result: In our results, TIVA with propofol enabled smooth and rapid induction in all patients with induction time of 29.7 seconds. In maintenance phase propofol provides adequate depth of anaesthesia assessed by haemodynamic changes and sympathetic over activity in 47 (92%) of the patients. Five patients (8%) needed higher dose of infusion to maintain adequate depth of anaesthesia. Recovery was good with short response time of 10.3 minutes and orientation time of 14.54 minutes. Conclusion: Our study concludes like others, Propofol based TIVA provides smooth and rapid induction and acceptable haemodynamic status during maintenance period in most of the patients. All patients were alert and clear headed with smooth recovery from anaesthesia effect.