Comparison of bleeding in propofol and isoflurane anesthesia in lumbar disc and cerebral hemorrhage surgery

Introduction: The current study compared the amount of bleeding in propofol and isoflurane anesthesia in patients undergoing lumbar disc and cerebral hemorrhage surgery in Birjand teaching hospitals within ۲۰۱۷-۲۰۱۸. Methods: This retrospective quasi-experimental study was conducted based on a nonequivalent group design. It was performed on patients within the age range of ۱۸-۷۵ years undergoing spinal surgery and cerebral hemorrhage who were referred to Imam Reza (AS) and Razi hospitals in Birjand within ۲۰۱۷-۲۰۱۸. Patient information was retrospectively collected using their medical records. The data were analyzed in SPSS software (version۱۶) using the independent t-test, paired t-test, and Mann-Whitney test. A p-value less than ۰.۰۵ was considered statistically significant. Results: A number of ۳۶ and ۳۵ patients underwent propofol and isoflurane anesthesia, respectively. Both groups were individually matched on gender, and the propofol patients were not significantly younger than the isoflurane patients (P=۰.۰۰۶). There was no significant difference between the two groups in terms of pre- and postoperative bleeding, hemoglobin level, systolic blood pressure, and diastolic blood pressure. Preoperative hemoglobin, systolic blood pressure, and diastolic blood pressure in the propofol group were reported as ۱۳.۸±۱.۶۹ g/dl, ۱۲۷.۲±۱۵ mmHg, and ۸۰±۸ mmHg, respectively. These values decreased to ۱۳.۰۳±۲.۰۱ g/dl (P=۰.۰۰۰۱), ۱۲۲.۳±۱۲.۸ mmHg (P=۰.۰۷۹), and ۷۶.۵±۹.۷ mmHg (P=۰.۰۳۴) postoperatively. On the other hand, in the isoflurane group, preoperative hemoglobin, systolic blood pressure, and diastolic blood pressure were obtained at ۱۳.۷±۱.۶۲ g/dl, ۱۲۸.۴±۱۸ mmHg, and ۷۸.۵±۱۲.۶ mmHg, respectively. These values also decreased to ۱۲.۸±۱.۹ g/dl (P=۰.۰۰۰۱), ۱۲۴.۱±۱۵.۸ mmHg (P=۰.۲۱۷), and ۷۶.۰±۱۱.۹ mmHg (P=۰.۳۶۵) postoperatively. Conclusions: Based on the obtained results, the amount of bleeding is similar in patients undergoing central nervous system surgery under either propofol or isoflurane anesthesia. Nevertheless, hypotension was higher in propofol-anesthetized patients. Inhaled anesthesia is advantageous over propofol anesthesia due to the possibility of metabolic acidosis in patients with controlled hypotension.