Comparing Perioperative Outcomes of Total Intravenous Anesthesia (TIVA) With Volatile Anesthesia in General Surgical Patients in a Tertiary Hospital of Bangladesh

Abstract

Background: The choice of anesthetic technique influences perioperative outcomes significantly with Total Intravenous Anesthesia (TIVA) and volatile anesthesia being the most common methods in general surgery. Objective: This study compares the perioperative outcomes of TIVA and volatile anesthesia in general surgical patients at Uttara Adhunik Medical College Hospital, Bangladesh, to determine which method results in better recovery and fewer complications. Methods: A total of 120 general surgical patients (60 per group) were randomly assigned to receive either TIVA or volatile anesthesia. Data was collected on emergence time, postoperative nausea and vomiting (PONV), recovery time, and hemodynamic stability. The outcomes were compared using statistical analysis (paired t-test, p-value < 0.05) and standard deviation to assess variability. Results: The TIVA group demonstrated a significantly faster emergence time with a mean of 8.3 ± 1.5 minutes compared to 12.1 ± 2.4 minutes in the volatile anesthesia group (p-value = 0.003). The incidence of PONV was lower in the TIVA group, with only 16% of patients experiencing nausea, compared to 36% in the volatile group (p-value = 0.02). Recovery room stay duration was also significantly shorter for the TIVA group (45.2 ± 9.1 minutes) versus the volatile group (56.5 ± 11.2 minutes), with a p-value of 0.04. Blood pressure fluctuations were significantly more stable in the TIVA group, showing a standard deviation of ±5.2 mmHg, while the volatile group had a higher fluctuation at ±7.6 mmHg (p-value = 0.01). Additionally, the TIVA group required 35% fewer rescue analgesics (p-value = 0.02). Conclusion: TIVA offers superior perioperative outcomes in terms of emergence time, recovery, postoperative complications, and hemodynamic stability compared to volatile anesthesia in general surgical patients at a tertiary hospital.