Blood loss during first trimester termination of pregnancy: comparison of two anaesthetic techniques

Abstract

We have compared the effects of two anaesthetic techniques on blood loss during suction termination of pregnancy. Forty-eight ASA grade I-II patients were allocated randomly to one of two groups: group 1 received propofol induction followed by a standard propofol infusion; group 2 received propofol induction followed by maintenance with 1% isoflurane. Both groups received bolus doses of either propofol (group 1) or isoflurane (group 2) if anaesthesia was too light. All patients were given fentanyl 1 micrograms kg-1 on induction. The products of conception were evacuated into a closed suction bottle. The products were diluted with 500 ml of heparinized saline, filtered and left for 20 min. Estimation of blood loss was performed by atomic absorption spectrometry. Mean blood losses were 40.4 ml for the isoflurane group and 18.8 ml for the propofol group. This difference was statistically significant (P = 0.0011), although actual volumes of blood loss were small and not clinically significant.

Blood Loss During Endoscopic Sinus Surgery With Propofol or Sevoflurane

“…In studies from other surgical specialties, propofol has been shown to decrease in-traoperative blood loss. [7][8][9] The disadvantages associated with using a TIVA technique over an IA technique include increased chance of error in programming the pump and the danger of IV infiltration resulting in an unexpected lessening of anesthesia depth.…”

Intraoperative Blood Loss during Induced Abortion: A Comparison of Anesthetics

“…All inhalational agents were used at 1.5 MAC and above, and such concentrations would likely be avoided in current practice. The following anesthesia concentrations were noted in a Hall et al study: patients received fentanyl one microgram/kilogram (kg), followed by an induction dose of propofol (2-3 mg/kg); then a propofol infusion was started using a standard regimen of 12 mg/kg/h for 10 min and then 9 mg/kg/h for 10 min; they also received bolus doses of propofol (20 mg) if anesthesia was too light; patients breathed 66% nitrous oxide in oxygen via face mask; in the second group, after preoxygenation, patients received fentanyl one microgram/kilogram followed by an induction dose of propofol (2-3 mg/kg); anesthesia was maintained with 1% isoflurane (measured concentration) and 66% nitrous oxide in oxygen via face mask; isoflurane concentration was increased by 0.5% and a further 0.5% if necessary, using a concentration of 1% isoflurane if the anesthesia was too light and when the patient was stable [11]. Few international studies have compared volatile anesthetics with propofol for minor gynecologic procedures, including induced abortion [12].…”

“…One Canadian study by Nathan et al was prematurely terminated in a prospective randomized study comparing the cost of sevoflurane and propofol during ambulatory induced abortion procedures due to an unacceptable increase in bleeding in the sevoflurane group [13]. Another prospective study completed in Wales by Hall et al found significantly more intraoperative blood loss with the use of inhaled isoflurane than with intravenous propofol [11]. The existing literature is approximately 20–30 years old, and the dosages cited are no longer recommended.…”

The effect of anesthetic agents on perioperative bleeding during tonsillectomy: Propofol‐based versus desflurane‐based anesthesia

“…Recent studies in other surgical specialties indicated that propofol generally decreased intraoperative blood loss. 5,6 However, the effect of propofol on bleeding in otolaryngologic operations such as endo-scopic sinus surgery, head and neck surgery, and otologic surgery is controversial. [7][8][9][10][11][12][13] Propofol is more expensive than desflurane, and the benefit of propofol at reducing hemorrhage is unknown in tonsillectomy.…”