COMPARISON OF HEMODYNAMIC STABILITY IN PATIENTS RECEIVING TOTAL INTRAVENOUS ANESTHESIA VS INHALATIONAL ANESTHESIA

Abstract

Background:
Maintaining hemodynamic stability during general anesthesia is a crucial aspect of perioperative care. Total Intravenous Anesthesia (TIVA) and inhalational anesthesia are commonly used techniques, each with distinct cardiovascular effects. Understanding their relative impact on hemodynamic parameters can improve patient safety, particularly in those at risk for cardiovascular complications.

Objective:
To compare hemodynamic stability in patients receiving Total Intravenous Anesthesia (TIVA) versus inhalational anesthesia during elective surgical procedures.

Methodology:
This comparative cross-sectional study was conducted at the Department of Anesthesiology, Hayatabad Medical Complex, Peshawar, Pakistan, over six months. A total of 188 patients undergoing elective surgery under general anesthesia were included and equally divided into TIVA (n=94) and inhalational anesthesia (n=94) groups. Patients aged 18–60 years, ASA I–II, and who provided informed consent were included. Intraoperative monitoring included heart rate, systolic and diastolic blood pressure, mean arterial pressure, and vasopressor requirement. Data were analyzed using SPSS, with independent t-tests for quantitative variables and chi-square tests for categorical variables. A p-value ≤ 0.05 was considered statistically significant.

Results:
Age distribution was comparable between groups, with most patients aged 31–45 years. Baseline hemodynamic parameters were similar. Post-intubation heart rate and mean arterial pressure were significantly higher in the inhalational group compared to the TIVA group (p < 0.05). The incidence of intraoperative hypotension, hypertension, and tachycardia was lower in the TIVA group. Vasopressor requirement was also significantly reduced in the TIVA group (11.7% vs 24.5%; p = 0.03).

Conclusion:
TIVA provides superior intraoperative hemodynamic stability compared to inhalational anesthesia, with lower incidence of cardiovascular fluctuations and reduced vasopressor requirement. TIVA may be preferred in patients where cardiovascular stability is critical