Less adrenergic activation during cataract surgery with total intravenous than with local anesthesia

Abstract

The presented study and available data clearly suggest that local anesthesia produces the best adrenergic and hemodynamic stability during cataract surgery. Contrary to previously reported results on inhalational anesthesia (thiopentone/enflurane), the TIVA regimen used effectively prevents the adrenergic and metabolic response during cataract surgery.

Effect of propofol and isoflurane anaesthesia on the immune response to surgery*

“…Thus, surgery decreases the Th1/Th2 ratio, which is responsible for the suppressed cell‐mediated immunity after surgery [13]. Since anaesthesia can suppress the stress response to surgical stimulation [14–17], it may inhibit the decrease in the Th1/Th2 ratio caused by surgery.…”

Wybór optymalnej metody znieczulenia podczas zabiegów przedniej resekcji odbytnicy — ocena

“…The smaller the trauma the smaller the stress response [30,31]. Minimal stress reaction, as a response to surgical stimuli from the operative field, accompanies ophthalmic procedures [32,33]. Therefore, Kushikata et al [34,35] conducted two studies in which they compared the neuroendocrine stress response to entirely intravenous anaesthesia, using propofol, with anaesthesia with balanced sevoflurane, in patients undergoing scheduled eye-related surgical procedures.…”

Comparison of isoflurane and propofol–fentanyl anaesthesia in a swine model of asphyxia

“…TIVA (n=10) P 40% MAP time (s) 378 (104) 498 (95) 0.02* 40% epinephrine (pg ml ±1 ) Q 10 4 1.6 (0.8) 5.6 (3.1) <0.01* 40% norepinephrine (pg ml ±1 ) Q 10 4 8. advantageous with regard to maintaining haemodynamics against the development of asphyxia-induced stress. Several investigators have reported that TIVA with propofol and opioids effectively blunts the adrenergic response to surgical stress, with a consecutive reduction in plasma catecholamine concentrations.…”