Comparison of bleeding in propofol and isoflurane anesthesia in lumbar disc and cerebral hemorrhage surgery

Abstract

Introduction: The current study compared the amount of bleeding in propofol and isoflurane anesthesia in patients undergoing lumbar disc and cerebral hemorrhage surgery in Birjand teaching hospitals within 2017-2018. Methods: This retrospective quasi-experimental study was conducted based on a nonequivalent group design. It was performed on patients within the age range of 18-75 years undergoing spinal surgery and cerebral hemorrhage who were referred to Imam Reza (AS) and Razi hospitals in Birjand within 2017-2018. Patient information was retrospectively collected using their medical records. The data were analyzed in SPSS software (version16) using the independent t-test, paired t-test, and Mann-Whitney test. A p-value less than 0.05 was considered statistically significant. Results: A number of 36 and 35 patients underwent propofol and isoflurane anesthesia, respectively. Both groups were individually matched on gender, and the propofol patients were not significantly younger than the isoflurane patients (P=0.006). There was no significant difference between the two groups in terms of pre- and postoperative bleeding, hemoglobin level, systolic blood pressure, and diastolic blood pressure. Preoperative hemoglobin, systolic blood pressure, and diastolic blood pressure in the propofol group were reported as 13.8±1.69 g/dl, 127.2±15 mmHg, and 80±8 mmHg, respectively. These values decreased to 13.03±2.01 g/dl (P=0.0001), 122.3±12.8 mmHg (P=0.079), and 76.5±9.7 mmHg (P=0.034) postoperatively. On the other hand, in the isoflurane group, preoperative hemoglobin, systolic blood pressure, and diastolic blood pressure were obtained at 13.7±1.62 g/dl, 128.4±18 mmHg, and 78.5±12.6 mmHg, respectively. These values also decreased to 12.8±1.9 g/dl (P=0.0001), 124.1±15.8 mmHg (P=0.217), and 76.0±11.9 mmHg (P=0.365) postoperatively. Conclusions: Based on the obtained results, the amount of bleeding is similar in patients undergoing central nervous system surgery under either propofol or isoflurane anesthesia. Nevertheless, hypotension was higher in propofol-anesthetized patients. Inhaled anesthesia is advantageous over propofol anesthesia due to the possibility of metabolic acidosis in patients with controlled hypotension.