Abstract

Objectives: We compared the effects of total intravenous anesthesia and inhalational anesthesia with sevoflurane on intra-abdominal pressure and cardiovascular and respiratory systems in patients undergoing surgery in the supine and prone positions.

Study Design: Thirty ASA I-II patients (17 males, 13 females; mean age 50 years; range 35 to 70 years) undergoing elective lumbar discectomy were randomly assigned to total intravenous anesthesia (group I, n=15) and inhalational anesthesia with sevoflurane (group II, n=15). In group I, after anesthesia induction with intravenous alfentanil and propofol, entubation was performed with atracurium. Anesthesia was maintained with alfentanil and decreasing doses of propofol. In group II, induction was obtained with intravenous propofol, entubation with atracurium, and maintenance with sevoflurane. Intra-abdominal pressure, arterial pressures, heart rate, peripheral oxygen saturation, and endtidal CO2 were monitored and recorded in the supine position before and after anesthesia induction, immediately after turning to the prone position, every 30 minutes throughout the operation, and immediately after extubation in the supine position.

Results: At all times of monitoring, no significant differences were found between the two groups with respect to intraabdominal pressure, hemodynamic and respiratory parameters.

Conclusion: Total intravenous anesthesia and sevoflurane anesthesia do not appear to affect intra-abdominal pressure, hemodynamic and respiratory parameters in both positions.

Keywords : Anesthesia, inhalation; cardiac output; heart rate; hemodynamic processes/physiology; pressure; prone position/physiology; respiratory mechanics/physiology; supine position/physiology