Comparison of the effects of TIVA and inhalation anesthetic techniques on olfactory functions and olfactory memory: a randomized prospective study

Yıl 2023, Cilt: 48 Sayı: 1, 11 - 19, 31.03.2023

Üstün Sezer Rahşan Dilek Okyay Hilal Ayoğlu Bengü Gülhan Köksal Gamze Küçükosman Özcan Pişkin Nilay Nur Gençoğlu Ferruh Ayoğlu Fikret Çınar Işıl Özkoçak Turan

https://doi.org/10.17826/cumj.1133058

Öz

Purpose: This study aimed to investigate the effects of different general anesthesia procedures on postoperative olfactory functions and olfactory memory.
Materials and Methods: This prospective study was conducted with 97 patients. Patients were divided into three groups based on anesthesia induction and maintenance technique: Group P (induction and maintenance with propofol), Group PS (induction with propofol, maintenance with sevoflurane), and Group S (induction with sevoflurane, maintenance with sevoflurane). Butanol threshold and olfactory identification tests were administered 30 minutes (min) before the operation (T1) and 30 min (T2), 8 hours (h) (T3) and 24 h (T4) after the operation.
Results: Butanol threshold values were increased at the T2 time point compared to baseline in all groups, which returned to baseline values at T3 only in Group P. There was a significant difference between Group P and Group S in terms of butanol threshold values at all time points except T1. When olfactory identification increased at T3 and T4 compared to baseline in Group P, there was a significant difference between T2, T3, and T4 time points in Group S, and between T2 and T3 time points in Group PS as compared to Group P.
Conclusion: Propofol only causes a temporary impairment in olfactory functions in the early period and does not alter olfactory memory.

Anahtar Kelimeler

Propofol, Sevoflurane, Olfactory functions, Olfactory memory

TİVA ile inhalasyon anestezi yöntemlerinin koku fonksiyonlarına ve koku hafızası üzerine etkisinin karşılaştırılması: randomize prospektif bir çalışma

Öz

Amaç: Bu çalışmada, farklı genel anestezi uygulamalarının postoperatif koku fonksiyonları ve koku hafızası üzerine olan etkilerinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Bu çalışma prospektif olarak 97 hasta ile yapıldı. Hastalar anestezi indüksiyonu ve idame yöntemine göre üç gruba ayrıldı; Grup P (propofol ile indüksiyon ve idame), Grup PS (propofol ile indüksiyon, sevofluran ile idame), Grup S (sevofluran ile indüksiyon ve idame). Butanol eşik ve koku identifikasyon testleri ameliyattan 30 dakika (dk) önce (bazal=T1), ameliyattan 30 dk (T2), 8 saat (s) (T3) ve 24 s sonra (T4) uygulandı.
Bulgular: Tüm gruplarda butanol eşik testi değerlerinin bazale göre T2 zamanında arttığı ve bu artışın sadece Grup P'de T3’te bazale döndüğü gözlendi. Butanol eşik testi değerleri açısından Grup P ile Grup S arasında, T1 hariç tüm zamanlarda anlamlı farklılık saptandı. Koku identifikasyonunun Grup P'de bazale göre T3 ve T4’de arttığı, Grup P ile karşılaştırıldığında ise; Grup S’de T2, T3 ve T4, Grup PS’de ise T2 ve T3 arasında anlamlı farklılık olduğu gözlendi.
Sonuç: Propofolün sadece erken dönemde koku fonksiyonlarında geçici bir bozukluğa sebep olur.

Anahtar Kelimeler

Koku işlevi, Propofol, Sevofluran, Koku hafızası

Kaynakça

• Hoskison EE. Olfaction, pheromones and life. J Laryngol Otol. 2013;127:1156-9.
• Çırpar Ö, Muluk NB, Arıkan OK. Koku bozuklukları. Bidder Tıp Bilimleri Dergisi. 2012;4:37-44.
• Konstantinidis I, Tsakiropoulou E, Iakovou I, A Douvantzi, S Metaxas. Anosmia after general anaesthesia: a case report. Anaesthesia 2009;64:1367-70.
• Henkin RI. Altered taste and smell after anesthesia: cause and effect. Anesthesiology 1995; 83:648-9.
• Dhanani NM, Jiang Y. Anosmia and hypogeusia as a complication of general anesthesia. J Clin Anesth 2012;24:231-3.
• Elterman KG, Mallampati SR, Kaye AD, Urman RD. Postoperative alterations in taste and smell. Anesth Pain Med 2014;4(4):e18527.
• Yiğit VB, Çınar F, Evren C, Uğur MB, Özdemir Y. Türk toplumu için koku tanımlama testi. KBB Uygulamaları 2015;3:91-6.
• Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 2010;63:834-40.
• Doty RL, Bartoshuk LM, Snow JB Jr. Causes of olfactory and gustatory disorders. In: Getchell TV, Doty RL, Bartoshuk LM, Snow JB Jr, editors. Smell and Taste in Health and Disease. New York: Raven Press; 1991. p. 449-62.
• Salmi E, Kaisti KK, Metsahonkala L, Oikonen V, Aalto S, Någren K, et al. Sevoflurane and propofol increase 11C-flumazenil binding to gammaaminobutyric acidA receptors in humans. Anesthesia and Analgesia 2004;99:1420-6.
• Levy L, Henkin R. Brain gamma-aminobutyric acid levels are decreased in patients with phantageusia and phantosmia demonstrated by magnetic resonance spectroscopy. Journal of Computer Assisted Tomography 2004;28:721-7.
• Jugovac I, Imas O, Hudetz AG. Supraspinal anesthesia: behavioral and electroencephalographic effects of intracerebroventricularly infused pentobarbital, propofol, fentanyl, and midazolam. Anesthesiology 2006;105:764-78.
• Cooper GM. Unexpected benefits of anaesthesia, Anaesthesia 1998;53:830
• Farzana N, Tewari P, Sureka S, Dixit A. Parosmia and dysgeusia after intravenous propofol-based general anesthesia: A case report. Ann Card Anaesth. 2022;25:112-5.
• Du W, Xu Z, Wang W, Liu Z. A case of anosmia and hypogeusia as a complication of propofol. .J Anesth. 2018;32:293-6.
• Kostopanagiotou G, Kalimeris K, Kesidis K, Matsota P, Dima C, Economou M, et al. Sevoflurane impairs post-operative olfactory memory but preserves olfactory function. Eur J Anaesthesiol 2011;28:63-8.
• Ram E, Vishne TH, Weinstein T, Beilin B, Dreznik Z. General anesthesia for surgery influences melatonin and cortisol levels. World J Surg. 2005;29:826-9.
• Saravanan B, Kundra P, Mishra SK, Surianarayanan G, Parida PK. Effect of anaesthetic agents on olfactory threshold and identification – A single blinded randomised controlled study. Indian J Anaesth. 2018 ; 62: 592-8.
• Dispersyn G, Pain L, Touitou Y. Propofol anesthesia significantly alters plasma blood levels of melatonin in rats. Anesthesiology. 2010;112: 333-7.
• Arai YC, Ueda W, Okatani Y, Fukaya T, Manabe M. Isoflurane increases, but sevoflurane decreases blood concentrations of melatonin in women. J Anesth. 2004;18:228-31.
• Fassoulaki A, Kostopanagiotou G, Meletiou P, Chasiakos D, Markantonis S. No change in serum melatonin, or plasma beta-endorphin levels after sevoflurane anesthesia. J Clin Anesth. 2007;19:120-4.