Patient well-being after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia.
BACKGROUND
The aim of this study was to assess postoperative patient well-being after total i.v. anaesthesia compared with inhalation anaesthesia by means of validated psychometric tests.


METHODS
With ethics committee approval, 305 patients undergoing minor elective gynaecologic or orthopaedic interventions were assigned randomly to total i.v. anaesthesia using propofol or inhalation anaesthesia using sevoflurane. The primary outcome measurement was the actual mental state 90 min and 24 h after anaesthesia assessed by a blinded observer using the Adjective Mood Scale (AMS) and the State-Trait-Anxiety Inventory (STAI). Incidence of postoperative nausea and vomiting (PONV) and postoperative pain level were determined by Visual Analogue Scale (VAS) 90 min and 24 h after anaesthesia (secondary outcome measurements). Patient satisfaction was evaluated using a VAS 24 h after anaesthesia.


RESULTS
The AMS and STAI scores were significantly better 90 min after total i.v. anaesthesia compared with inhalation anaesthesia (P=0.02, P=0.05, respectively), but equal 24 h after both anaesthetic techniques (P=0.90, P=0.78, respectively); patient satisfaction was comparable (P=0.26). Postoperative pain was comparable in both groups 90 min and 24 h after anaesthesia (P=0.11, P=0.12, respectively). The incidence of postoperative nausea was reduced after total i.v. compared with inhalation anaesthesia at 90 min (7 vs 35%, P<0.001), and 24 h (33 vs 52%, P=0.001).


CONCLUSIONS
Total i.v. anaesthesia improves early postoperative patient well-being and reduces the incidence of PONV.
Institute of Anaesthesiology, Triemli City Hospital, Birmensdorferstr. 497, CH-8063 Zurich, Switzerland.
C K
CK
Hofer
A
A
Zollinger
S
S
Büchi
R
R
Klaghofer
D
D
Serafino
S
S
Bühlmann
C
C
Buddeberg
T
T
Pasch
D R
DR
Spahn
D000328:Adult; D000339:Affect; D000368:Aged; D000769:Anesthesia, Inhalation / Q000523:psychology*; D000771:Anesthesia, Intravenous / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013511:Minor Surgical Procedures; D010149:Postoperative Pain; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D016896:Treatment Outcome