Anesthetic Techniques for Pharyngeal Flap Surgery: Effects on Postoperative Complications

OBJECTIVE To assess the effects of 2 different anesthetic techniques on early complications after superior pharyngeal flap surgery. DESIGN Randomized, prospective, single-blind study. SETTING Large referral hospital. PATIENTS One hundred patients undergoing superior pharyngeal flap surgery for the c...

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Bibliographic Details
Published in:	Archives of otolaryngology--head & neck surgery Vol. 128; no. 1; pp. 35 - 39
Main Authors:	Bennun, Meir, Goldstein, Bernardo, Zohar, Edna, Finkelstein, Yehuda, Jedeikin, Robert, Fredman, Brian
Format:	Journal Article
Language:	English
Published:	Chicago, IL American Medical Association 01-01-2002
Subjects:	Adolescent Adult Anesthesia, General Anesthesia, Inhalation Anesthetics, Inhalation Anesthetics, Intravenous Biological and medical sciences Child Child, Preschool Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Humans Isoflurane Medical sciences Non tumoral diseases Otorhinolaryngologic Surgical Procedures Otorhinolaryngology. Stomatology Pharynx - surgery Postoperative Complications Propofol Prospective Studies Single-Blind Method Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the upper aerodigestive tract Surgical Flaps Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Human Postoperative Pharynx Result Prospective Communication disorder Treatment Surgery ENT disease Anesthesia Complication Early Pharynx disease Speech articulation disorder Technique Flap (surgery) Velopharyngeal insufficiency
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Summary:	OBJECTIVE To assess the effects of 2 different anesthetic techniques on early complications after superior pharyngeal flap surgery. DESIGN Randomized, prospective, single-blind study. SETTING Large referral hospital. PATIENTS One hundred patients undergoing superior pharyngeal flap surgery for the correction of velopharyngeal insufficiency were randomly divided into 2 equal groups to receive either isoflurane or propofol-based anesthesia. INTERVENTIONS Following induction of anesthesia with fentanyl citrate and propofol, patients were randomized to receive either isoflurane or propofol for the maintenance of general anesthesia. The inspired isoflurane concentration and propofol infusion rate were adjusted to maintain a stable depth of anesthesia as judged by clinical signs and hemodynamic responses to surgical stimuli. MAIN OUTCOME MEASURES Recovery from anesthesia, recovery from surgery, and early postoperative complications. RESULTS The groups were similar in age, weight, height, induction time, surgery time, extubation time, and anesthetic time. The time (mean ± SD) required to achieve a maximal Steward Recovery Score was 7 ± 14 minutes in the propofol group compared with 32 ± 28 minutes in the isoflurane group (P<.04). No significant differences in postoperative patient satisfaction scores, time to first swallow, drinking time, and time to "home readiness" were noted. Overall, 17 patients (17%) developed airway-related complications and 2 of the patients (2%) were accounted as severe. Two patients (2%) bled from the operation site. However, there was no difference in the incidence of postoperative complications between the groups. CONCLUSIONS When compared with isoflurane administration for maintenance of general anesthesia, propofol-based anesthesia was associated with more rapid mental and psychomotor recovery. However, airway-related complications and "home readiness" were similar between the groups.Arch Otolaryngol Head Neck Surg. 2002;128:35-39-->
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0886-4470 2168-6181 1538-361X 2168-619X
DOI:	10.1001/archotol.128.1.35