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Comparative Study
. 2010;65(10):941-6.
doi: 10.1590/s1807-59322010001000003.

The influence of various anesthesia techniques on postoperative recovery and discharge criteria among geriatric patients

Dilsen Ornek  1 , Seyhan Metin, Serpil Deren, Canan Un, Mustafa Metin, Bayazit Dikmen, Nermin Gogus
Affiliations
Comparative Study

The influence of various anesthesia techniques on postoperative recovery and discharge criteria among geriatric patients

Dilsen Ornek et al. Clinics (Sao Paulo). 2010.

Abstract

Objective: We aim to compare selective spinal anesthesia and general anesthesia with regard to postoperative recovery and fast-track eligibility in day surgeries.

Materials and method: Sixty geriatric outpatient cases, with ASA II-III physical status and requiring short-duration transurethral intervention, were enrolled in the study. The cases were split into 2 groups: as general anesthesia (Group GA) and selective spinal anesthesia (Group SSA). Group GA (n = 30) received propofol 2 mg kg⁻¹ (until loss of eyelash reflex), remifentanil induction 0.5-1 µg kg⁻¹, and laryngeal mask. Maintenance was achieved by 4-6% desflurane in 60% N₂O and 40% O₂ along with remifentanil infusion at 0.05 µg /kg⁻¹ /min⁻¹. Drugs were discontinued after the withdrawal of the ureteroscope, and extubation was carried out with 100% O₂. Group SSA (n = 30) received 0.5% spinal anesthesia via L4-5 space by 0.5% hyperbaric bupivacaine 5 mg. Anesthesia preparation time, time to surgical anesthesia level, postoperative fast-tracking, and time to White-Song recovery score of 12, were noted. In the operating room, we evaluated hemodynamics, nausea/vomiting, surgeon and patient satisfaction with anesthesia, perioperative midazolam-fentanyl administration, postoperative pain, and discharge time.

Results: Anesthesia preparation time, length of surgery, anesthesia-related time in the operating room, time to sit, and time to walk were significantly low in Group GA (p < 0.05), whereas time to fast-track eligibility, length of stay in the PACU, discharge time, and other parameters were similar in both of the groups.

Conclusion: While anesthesia preparation time, length of surgery, start time of surgery, time to sit, and time to walk were shorter in the General Anesthesia group, time to fast-track eligibility, phase 1 recovery time, and discharge time were similar among patients subjected to selective spinal anesthesia.

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Figures

Figure 1
Figure 1
Average changes in blood pressure. Pre: preinduction, Post:postinduction, Pex: post‐extubation
Figure 2
Figure 2
Average changes in heart rate. Pre: preinduction, Post:postinduction, Pex: post‐extubation
Figure 3
Figure 3
Distribution of SpO2 over time. Pre: preinduction, Post:postinduction, Pex: post‐extubation
See this image and copyright information in PMC

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