A comparative Study Between Total Intra-Venous Anaesthesia (TIVA) and Volatile Induction & Maintenance of Anaesthesia (VIMA) For Laparoscopic Surgery

Abstract

The most profound alteration of surgical techniques in the 20th century has been the introduction of laparoscopy. Common laparoscopic procedures are appendectomy, cholecystectomy, fundoplication, inguinal hernia repair, tubal ligation, nephrectomy, splenectomy and diagnostic laparoscopy. The advantages include the cosmetic results of small incisions, decreased blood lost, less postoperative pain and ileus, shorter hospitalization, ultimately lower cost and better postoperative respiratory muscle function than laparotomy. C02 is the gas of choice for laparoscopy. The head-down position is used in pelvic surgery while the head-up position is used for upper abdominal procedures. Both positions contribute to changes in gas exchange and/or respiratory mechanics. The haemodynamic changes during laparoscopy result from both patient position and PP. Some complications can occur during laparoscopy and mortality rate aftyr laparoscopy is 0.2% which is similar to open laparotomy. Total intra-Venous Anaesthesia (TIVA) is a relatively new anaesthetic

technique, which may offer advantages over. the traditional inhalational techniques. Propofol is the only currently available intravenous anaesthetic with an appropriate phrmacokinetics for TIVA. Recently, Target Controlled Infusion (TCI) has been introduced. It combines a pharmacokinetic model with an infusion pump and allows the administration and maintenance of a constant blood concentration to some intravenous drugs. A TCI system for propofol is now available. Volatile Induction and Maintenance of Anaesthesia (VIMA) is an old anaesthetic technique, which was used with chloroform and ether. Halothane is a very common inhalational agent for VIMA in children. Recently Sevoflurane