Recovery after total intravenous anesthesia (TIVA) using propofol and inhalation anesthesia (IA) using halothane in day case surgery.

The aims of this study were to compare recovery by clinical tests, the Perceptual Speed Test (PST) and the Ball Bearing Test (BBT), home recovery, side effects and satisfaction of anesthesia between total intravenous anesthesia using propofol and inhalation anesthesia using halothane in day case surgery and to determine average cost per case of each technique from the provider's the perspective. Forty patients were randomly allocated into TIVA and IA groups. The anesthetic times were 42.1 +/- 26.47 minutes and 37.6 +/- 14.75 minutes respectively. Recovery was assessed by the time to orientation, sitting up, standing up and to success in obtaining baseline values of the PST & BBT. The observer was blinded to the anesthetic technique that the patient received. Recovery tests showed no difference between the two groups. The recovery times of TIVA and IA as assessed by the PST and BBT were 1.2 +/- 0.41 and 1.1 +/- 0.31 hour respectively. From a home questionnaire, both groups showed no difference in the first 2-3 hours of home recovery, incidence of side effects and satisfaction of anesthesia. When asked about the difficulty in getting home, no TIVA patients complained of sleepiness whereas 6/16 IA patient did (p = 0.018). The average cost per case of TIVA and IA was 642.15 and 363.15 bahts respectively.

Comparison of immediate recovery period among young, middle-aged and elderly patients.

We reported the immediate recovery period of 705 consecutive patients post general or head-neck-breast surgery, 590 were looked after in the recovery room (RR) and 115 were admitted into the intensive care unit (ICU) right after surgery. Group I were "young" (aged 15-45 years), group II were "middle aged" (46-60 years) and group III were "elderly" (> 60 years). Twenty-seven per cent of the elderly patients were sent to the ICU, whereas, 8.4 per cent of the young and 14.7 of the middle-aged group were looked after in the ICU. In RR patients, the young group were in better ASA class and had significantly fewer underlying diseases than the middle-aged and elderly groups; the most common of which were hypertension, diabetes and anemia. Elderly patients spent a significantly longer time in the RR than the young group but the risk of complication was not different. The most frequent complication was pain and elderly patients more frequently suffered from pain than the young group. Post-anesthetic recovery score (after Aldrete and Kroulik) was lower in the elderly on arrival and at 15, 30, 60 minutes in the RR but there was no clinical significance. In ICU patients, the 3 groups' intubation rates were not different and although the duration of intermittent positive pressure ventilation and duration of stay in the ICU were longest in the elderly group, there was no statistically significant difference. The mortality rate was highest in the elderly. We concluded that elderly patients had a worse immediate recovery period.