Effect of Propofol TIVA Compared Sevoflurane Inhalation Anesthesia on Triglyceride Levels After Elective Craniotomy Surgery

Abstract

Background: Propofol TIVA has been shown to be more effective than sevoflurane in craniotomy surgery. Propofol TIVA offers the benefit of giving better brain relaxation during surgery while also being less expensive than sevoflurane. Nonetheless, it is important to highlight that propofol has side effects that should be considered. Large doses and prolonged anesthesia may result in increased triglycerides (lipids) as well as Propofol Infusion Syndrome (PRIS). As part of their investigation into the detrimental effects of propofol, researchers discovered the necessity for controls to avoid confusing the effects of the surgery itself. Therefore, sevoflurane was chosen as the control group to comprehend and analyze the effects of propofol more accurately. Methods: A prospective observational study analysis was conducted on elective craniotomy patients at RSUD Dr. Soetomo from November to December 2023. 52 subjects were divided into two groups, namely the TIVA Propofol and Sevoflurane Inhalation groups. Each group will be examined for preoperative triglyceride levels and postoperative triglyceride levels while already in the ICU. Results: Postoperative triglyceride levels in the Propofol TIVA group were significantly higher. In the comparison test between the two anesthesia methods on triglyceride levels, there was a significant effect in the Propofol TIVA group. In the test of the relationship between the duration of anesthesia in both groups, there was no significant relationship. In the test of the relationship between the total dose of propofol and triglyceride levels, it was found that the greater the dose of propofol used, the higher the increase in triglyceride levels. In the test of the relationship between the total amount of sevoflurane and triglyceride levels, it was found that the greater the dose of sevoflurane used, the greater the decrease in triglyceride levels, which was statistically not significant. Conclusion: TIVA Propofol increases triglyceride levels compared to sevoflurane inhalation in patients undergoing elective craniotomies. Keywords: Craniotomy, Triglycerides, TIVA propofol, Sevoflurane.