Comparative evaluation of the effects of two methods of anesthesia management on outcome of wake-up test during constructive spinal column surgery

Abstract

Background: Wake-up test is one of the diagnostic tests for preventing permanent and severe damages during reconstruction surgeries of spinal columns. In this study, application of haloperidol and propofol were compared in improving speed and quality of this test. Methods: In a clinical trial study, 42 candidates of scoliosis reconstruction surgeries were randomly divided in 2 groups. In case group, intravenous haloperidol (0.1 mg/kg), 50 nitrous oxide in oxygen plus atracurium (1.5 mg/kg), and fentanyl (1 μg/kg q 30 minutes) were used for maintenance of anesthesia; and in control group, propofol (0.6 mg/kg/hour), remifentanil 0.15 (μg/kg/hour), and atracurium 0.15 (mg/kg q 30 minutes) were prescribed. Two groups were compared in quality and speed of wake-up test and some hemodynamic and respiratory indices. Findings: Patients in case and control groups had statistical differences in mean arterial pressure (79.73 ± 2.60 and 81.36 ± 2.60 mmHg, respectively, P= 0.029), heart rate (88.26 ± 3.90 and 92.78 ± 5.20, respectively, P = 0.040) and SpO2 (P < 0.001). In haloperidol and propofol groups, the mean of wake-up time in wake-up tests was 2.38 ± 0.66 and 11.52 ± 2.44 minutes, respectively (P < 0.001), and the mean extubation time was 296.40 ± 153.71 and 393.33 ± 319.18 seconds, respectively (P < 0.001). Conclusion: Application of haloperidol for maintenance of anesthesia in scoliosis reconstruction surgeries has better quality and faster waking time in comparison to propofol while preserving suitable hemodynamic and respiratory parameters. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.