Comparison of effect of sevoflurane low flow anesthesia and total intravenous anesthesia on intraoperative awakeness, postoperative recovery and postoperati̇ve nausea-vomiting at middle EAR operations

Firstly, the aim of this study is to compare the affect of low flow sevofulurane anesthesia and total intravenous anesthesia on intraoperative awareness, postoperative recovery and postoperative nausea and vomiting . There are 80 patients between 16 to 60 age in ASA I-II risk groups were included in this study.These patients were seperated to randomise groups. During the anesthesia induction, 1mcq/kg fentanyl 1mg/kg lidocaine, 2mg/kg propofol and 0.15 mg/kg cisatracurium were enjected. Before the entubation period, these patients were ventileted that like tidal volume is 8-10 ml/kg, frequency is 10-12 per minute and end-tidal is CO2 parciel pressure 35-40mmHg . At the maintenance of anesthesia, %50 O2 and %50 air were delivered to all of the patients. 50mcq/kg/dk propofol and 0.2 mcq/kg/dk remifentanyl were infused to group T , 0.2 mcq/kg/dk remifentanyl, %1.5 sevoflurane were used to group D.BIS value were tried to keep between 40 and 60 for the patients who monitorised with BIS.The heart rate, saturation of oxygen, mean arterial pressures and BIS values have been recorded before and after induction in 0th ,5th , 10th , 15th , 30th , 45th , 60th , 75th , 90th , 105th and 120th minute.Duration of moving spontaneously, spontaneous eye opening time, extubation time, handshaking with command and orientation time from the finishing of anesthesia have been recorded. When the cases has arrived in the postoperative care unit, they were evaluated according to Modified Aldrette Scoring in 0th, 5th, 7th, and 10th minute. After that, when the total score has reached to 9 and upper from that, this duration has been recorded and they evaluated for postoperative awakeness befor they were sent the service.Postoperative nausea and vomiting were evaluated at the postoperative 0-2th, 2-6th, 6-24th hours with VDS. There was no difference between this two groups for demographic data, intraoperative awereness, use of additional anesthesic drugs and VDS.The dose of remifentanly which used during the operation was meaningfully high in the cases who were in TIVA group from others.The duration of extubation, starting time of the spontaneous movement, spontaneous eye opening time, orientation time, the duration of Aldrette score reaches 9-10 were significantly high at the group who were in low flow anesthesia.0th minute Aldrette score, mean arterial pressure in ,15th, 30th, 75th and 90th minute after entubation ; values of BIS in 5th, 10th minute after entubation and after extubation, were meaningfully high. As a result, for the anesthesia of middle ear surgery, there were shorter recovery time in TIVA group according to low flow sevoflurane anesthesia, therefore we could say that both techniques are used with confidence. Key words: low flow anesthesia, sevoflurane, TIVA, BIS, PONV