RESUMEN
Objectives: Hypotensive anesthesia is necessary during endoscopic sinus surgery to achieve a bloodless surgical field. The aim of this study was to compare the quality of surgical field using propofol or desflurane anesthesia
Methodology: 40 patients of either sex, belonging to ASA physical status I and II, and age group of 18 - 60 years were randomized into two groups to receive either propofol and morphine or desflurane and morphine anesthesia. The target mean arterial pressure [MAP] was kept in a range of 65-75 mmHg. The quality of surgical field was assessed by using a validated scoring system [Fromme category scale] at every 15 min by the same surgeon in all the cases to avoid surgeon's bias
Results: The mean category scale value was 2.665 +/- 0.243 in propofol group and 2.200 +/- 0.410 in desflurane group [p=0.000]. The time to emergence was significantly less in desflurane group [9.35 +/- 1.27] as compared to propofol group [14.60 +/- 2.06 min]
Conclusion: We conclude that both the propofol and desflurane can be used to achieve a satisfactory surgical field quality but desflurane provides a rapid emergence as compared to propofol
RESUMEN
The various studies conducted till date reveal that up to 40% patients undergoing coronary artery bypass surgery are associated with minor or persistent neuropsychological disorders. A significant concern has been emphasized on short and long term morbidity in cases of CABG procedure. The outcome in the form of morbidity after this surgery, irrespective of co-existing medical diseases, is prevalent in presence of neuropsychological problems, such as anxiety, depression and cognitive impairments, though the exact mechanism of this behavioural aspect is obscure. As such, there may not be serious psychological dysfunction but chances of incident delirium at the time of admission are quite high. These neuropsychological deficits may continue over time, especially if the features persisted in preoperative period, too. To improve the detection of these psychological disorders in CABG surgery cases, the clinicians must consider the use of specified screening methods. Perioperative factors, as well as patientrelated risk factors, play a vital role in development of cognitive dysfunctions. Recent literature emphasizes the possibility of a grave complication in the form of ischaemic stroke in post- CABG surgical patients. The microemboli may enter cerebral circulation during surgery leading to cognitive decline, postoperatively. In the recent literature, that include various studies covering the neuropsychological areas, conflicts and limitations in methodology are prevalent