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Anesthetic Techniques for Pharyngeal Flap Surgery
Effects on Postoperative Complications
Meir Bennun, MD;
Bernardo Goldstein, MD;
Edna Zohar, MD;
Yehuda Finkelstein, MD;
Robert Jedeikin, BSc, MB, ChB, FFA(SA);
Brian Fredman, MB, BCh
Arch Otolaryngol Head Neck Surg. 2002;128:35-39.
Objective To assess the effects of 2 different anesthetic techniques on early
complications after superior pharyngeal flap surgery.
Design Randomized, prospective, single-blind study.
Setting Large referral hospital.
Patients One hundred patients undergoing superior pharyngeal flap surgery for
the correction of velopharyngeal insufficiency were randomly divided into
2 equal groups to receive either isoflurane or propofol-based anesthesia.
Interventions Following induction of anesthesia with fentanyl citrate and propofol,
patients were randomized to receive either isoflurane or propofol for the
maintenance of general anesthesia. The inspired isoflurane concentration and
propofol infusion rate were adjusted to maintain a stable depth of anesthesia
as judged by clinical signs and hemodynamic responses to surgical stimuli.
Main Outcome Measures Recovery from anesthesia, recovery from surgery, and early postoperative
complications.
Results The groups were similar in age, weight, height, induction time, surgery
time, extubation time, and anesthetic time. The time (mean ± SD) required
to achieve a maximal Steward Recovery Score was 7 ± 14 minutes in the
propofol group compared with 32 ± 28 minutes in the isoflurane group
(P<.04). No significant differences in postoperative patient
satisfaction scores, time to first swallow, drinking time, and time to "home
readiness" were noted. Overall, 17 patients (17%) developed airway-related
complications and 2 of the patients (2%) were accounted as severe. Two patients
(2%) bled from the operation site. However, there was no difference in the
incidence of postoperative complications between the groups.
Conclusions When compared with isoflurane administration for maintenance of general
anesthesia, propofol-based anesthesia was associated with more rapid mental
and psychomotor recovery. However, airway-related complications and "home
readiness" were similar between the groups.
From the Departments of Anesthesiology and Critical Care Medicine (Drs
Bennun, Goldstein, Zohar, Jedeikin, and Fredman) and Otolaryngology, Head
and Neck Surgery (Dr Finkelstein), Meir Hospital, Sapir Medical Center, Kfar
Saba, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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