DOI: https://doi.org/10.21203/rs.3.rs-1430341/v1
Objective: The purpose of this study is to investigate the effects of high noise level on propofol and remifentanyl consumption in patients who undergo cholecystectomy surgery under total intravenous anaesthesia (TIVA) during operation and on the satisfaction of patients and physicians.
Subjects and Methods: 90 patients who would undergo cholecystectomy surgery were randomized in 3 groups in this study planned as a double blind, prospective, randomized clinical trial. Propofol and remifentanyl infusion was started to obtain BIS values between 40-60 for all patients. The patients in Group N (n=30) were subjected to noise of normal operating room. The patients in Group S (n=30) were subjected to noise between 80-85 Db with headphone and for patients in Group Q subjection to noise of the operating room was prevented by covering the ears with headphones (n=30). Intraoperative total remifentanyl and propofol consumption of the patients, postoperative patient and physician satisfaction, postoperative side effects were recorded.
Results: Total remifentanyl and propofol used during surgery was significantly lower in Group Q than in Group N and Group S (p=0,0001, p=0,04). Postoperative patient satisfaction in Group Q was statistically higher than in Group N and Group S (p=0.001). Surgeon satisfaction in Group Q was also higher than in Group N and Group S (p=0.01).
Conclusion: High noise level for patients who undergo cholecystectomy surgery under TIVA increases total remifentanyl and propofol consumption during operation. In addition, it decreases patient and surgeon satisfaction.
Table 1
Demographic Data, Recovery time, Duration of surgery, Total Remifentanil Consumption and Total Propofol Consumption of the Groups.
|
|
Group S (n=30) |
Group N (n=30) |
Group Q (n=30) |
p |
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|
Age (years) |
44.1±15.4 |
40.8±13.11 |
45.8±13.7 |
>0.05 |
|||
|
Weight (kg) |
73.0±14.9 |
73.8±15.7 |
72.9±13.4 |
>0.05 |
|||
|
Gender (M/F) |
13/17 |
10/20 |
|
|
|
9/21 |
>0.05 |
|
Body Mass Index (BMI) |
26.2±5.8 |
26.9±4.9 |
26.2±5.0 |
>0.05 |
|||
|
ASA I/II |
1/29 |
7/23 |
8/22 |
>0.05 |
|||
|
Recovery time (minutes) |
8.9±2.1 |
9.3±1.9 |
8.8±1.9 |
>0.05 |
|||
|
Duration of surgery (minutes) |
113.1±32.1 |
95.8±27.6 |
103.6±23.4 |
>0.05 |
|||
|
Total Remifentanil Consumption (mg) |
2.3±0.6 |
2.1±0.5 |
1.3±0.4* |
0.0001 |
|||
|
Total Propofol Consumption (mg) |
855.0±310.0 |
743.1±181.2 |
690.4±267.1* |
0.04 |
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|
Values are represented as means ± SD *p= 0.0001 when compared group Q with group N and group S |
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Table 2
The Anxiety, Sedation and the Satisfaction Scores of the Groups.
|
|
Group S (n=30) median (min-max) |
Group N (n=30) median (min-max) |
Group Q (n=30) median (min-max) |
p |
|
Preoperative Anxiety Score |
3.0 (2.0-3.0) |
2.0 (2.0-3.0) |
2.0 (2.0-2.0) |
>0.05 |
|
Postoperative Anxiety Score |
2.0 (2.0-3.0) |
2.0 (1.0-3.0) |
2.0 (1.0-3.0) |
>0.05 |
|
Preoperative Sedation Score |
2.0 (2.0-3.0) |
2.0 (2.0-3.0) |
2.0 (2.0-3.0) |
>0.05 |
|
Postoperative Sedation Score |
2.0 (2.0-3.0) |
2.0 (2.0-3.0) |
2.0 (2.0-3.0) |
>0.05 |
|
Postoperative Patients’ Satisfaction Scores |
2.0 (2.0-2.0) |
2.0 (1.0-3.0) |
2.0 (1.0-3.0)* |
<0.05 |
|
Postoperative Surgeons’ Satisfaction Scores |
2.0 (2.0-3.0) |
2.0 (2.0-3.0) |
3.0 (1.0-3.0)* |
<0.05 |
| *p< 0.05 when compared group Q with the group S and group N. | ||||
Table 3
The Postoperative Side Effects of the Groups.
|
|
Group S (n=30) n (%) |
Group N (n=30) n (%) |
Group Q (n=30) n (%)
|
|
Nausea-Vomiting |
5 (16.6%) |
1 (3.3%) |
4 (13.3) |
|
Bradycardia (beat/min) |
0 (0%) |
1 (3.3%) |
0 (0%) |
|
Tachycardia (beat/min) |
5 (16.6%) |
9 (30%) |
7 (23.3%) |
|
Hypertension (mm Hg) |
7 (23.3%) |
0 (0%) |
2 (6.6%) |
|
Hypotension (mm Hg) |
1 (3.3%) |
0 (0%) |
0 (0%) |
|
Caughing |
00 (0%) |
7 (23.3%) |
6 (20%) |
|
n= 30, data was showed as n (%) p> 0.05 when compared amongs the groups. |
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