Purpose: Diagnostic bronchoscopy is performed under general anesthesia in our hospital. This study was designed to determine whether total intravenous anesthesia (TIVA) with propofol-fentanyl provides more stable hemodynamics using a laryngeal mask airway (LMA) for diagnostic bronchoscopy than thiopental-sevoflurane anesthesia.
Methods: Sixty patients scheduled for diagnostic bronchoscopy were randomly assigned to two groups. TIVA with propofol-fentanyl was induced with intravenous fentanyl 2 μg·kg-1 and propofol 2 mg·kg-1 and maintained with continuous infusion of propofol with fentanyl. Thiopental-sevoflurane anesthesia was induced with thiopental 5 mg·kg-1 and maintained with N2O/O2/sevoflurane. Insertion of the LMA was facilitated with vecuronium 0.1 mg·kg-1 i.v. in both groups. Ventilation was controlled, and administration of propofol and sevoflurane was continued until the end of the procedure. The LMA was removed when the patient was able to open his or her mouth.
Results: During TIVA, the mean arterial pressure and rate pressure product decreased significantly from induction until 20 min after the start of the procedure, and they were maintained at around 70 mmHg and 7000, respectively, during the procedure. There were no significant differences in heart rate,[Formula: see text] and[Formula: see text]. In thiopental-sevoflurane anesthesia, the mean arterial pressure and rate pressure product decreased significantly after induction and increased significantly from insertion of the LMA until removal of the LMA. Heart rate increased significantly after insertion of the LMA, insertion of the bronchoscope, and removal of the LMA. There were no significant differences in[Formula: see text] and[Formula: see text].
Conclusion: TIVA with propofol-fentanyl in conjunction with an LMA performs better than thiopental-sevoflurane anesthesia for diagnostic bronchoscopy because of its superior maintenance of cardiovascular stability.
Keywords: Bronchoscopy; Laryngeal mask airway; TIVA with propofol-fentanyl.