Cardiovascular Effects of Volatile Induction and Maintenance of Anesthesia (VIMA) and Total Intravenous Anesthesia (TIVA) for Laryngeal Mask Airway (LMA) Anesthesia: A Comparison Study

Wariya Sukhupragarn MD*, Prangmalee Leurcharusmee MD*, Thitipan Sotthisopha MD*

Affiliation : * Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Objective : To compare changes of heart rate and blood pressure in patients that underwent LMA anesthesia with VIMA or TIVA technique. Material and Method: A hundred healthy patients, age 16 to 60 years were enrolled. They were randomized into two groups. Patients in group V (VIMA) were induced with 8% sevoflurane until loss of eyelash reflexes then controlled ventilation for five minutes before LMA insertion. Group T (TIVA) patients were given propofol to reach the affected site concentration of eight mcg/ml for the LMA insertion. Blood pressure and heart rate were recorded before induction, immediately before and after LMA insertion then every two minutes until surgical incision.
Results : Decreased SBP from baseline in group T was significantly more than group V in each period of time (D1-D7). DBP in group T decreased more than group V significantly only at eight and ten minutes after LMA insertion. The incidence of decreasing SBP >20% from baseline was more significant in group T than group V. No significant difference of changed HR was found. Coughing during LMA insertion occurred in eight patients (16%) in group T and in three patients (6%) in group V (p = 0.11).
Conclusion : Induction with propofol by effective site concentration of eight mcg/ml significantly decreased SBP more than with 8% sevoflurane. Both techniques provided smooth LMA insertion without serious complication.

Keywords : TIVA, VIMA, LMA, Total intravenous anesthesia, Volatile induction and maintenance of anesthesia, Laryngeal mask airway

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