Total Intravenous Anesthesia for Elective Videolaparoscopic Surgery in Geriatric Patients

Abstract

Introduction: The appearance of short-acting anesthetic drugs encouraged anesthesiologists to consider a new approach to videolaparoscopic surgery in the aged adult. Intense analgesia, reduced opioid consumption, rapid recovery of consciousness and spontaneous ventilation; early extubation, reduced complications, and shorter hospital stay.

Objective: To assess, in geriatric patients scheduled for elective videolaparoscopic cholecystectomy, the effect of total intravenous anesthesia with the association ketamine/propofol compared to fentanyl/propofol.

Methods: A quasiexperimental study was carried out at Hospital Universitario “Faustino Pérez Hernández”, of Matanzas Province, in forty patients aged sixty years or older, scheduled for elective videolaparoscopic surgery and with a physical condition of II-III according to the ASA classification.

Results: The average age ranged between 63 and 78 years, with a superiority of the female sex and the white race. The ASA II classification was the most representative in both groups. Cardiovascular history prevailed, there was a slight decrease in exhaled CO2 values with respect to baseline values, without significant differences. There was a variation in mean arterial tension indistinctly in both groups. In group 1, postinduction heart rate decreased (70±5 beats per minute) and values were lower than baseline during the first twenty minutes. Mean recovery time was significantly lower in group 2.

Conclusions: The ketamine/propofol association provides positive final results.