Chan 1996.
Methods | RCT, parallel design, single‐centre | |
Participants |
Total number of randomized participants: 60 Inclusion criteria
Exclusion criteria
Type of surgery: total hip replacement Baseline characteristics TIVA group
Inhalational maintenance group
Country: Canada Setting: hospital |
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Interventions |
TIVA group Participants: n = 29; 0 losses Induction details: propofol at 0.75 mg/kg/min via electronic pump. Succinylcholine 1.0 mg/kg to 1.5 mg/kg to facilitate tracheal intubation Maintenance details: 60% N2O in O2. Propofol increased/decreased by 50% in response to 25% change in baseline BP or HR. Fentanyl 1 µg/kg (to a maximum of 4 µg/kg) with increase of propofol. Intraoperative muscle relaxation maintained with vecuronium. Propofol discontinued 5 minutes before end of surgery, N2O and O2 continued until end of surgery. Postoperative pain management with IV morphine as required. Use of clinical parameters (HR and BP) to monitor depth of anaesthesia Other information: evening before surgery, participants were given triazolam 0.125 mg to 0.25 mg, if required. Participants usual medication was withheld on morning of surgery. Then as premedication given 10 mL/kg IV crystalloid, then vecuronium 1 mg, and fentanyl 0.75 µg/kg Inhalational maintenance groups Participants: n = 31; 0 losses Induction details : bolus of 2 mg/kg thiopental, titrated to 4 mg/kg within 60 seconds as necessary. Succinylcholine 1.0 mg/kg to 1.5 mg/kg to facilitate tracheal intubation Maintenance details: 60% N2O in O2. 0.5% to 1.5% isoflurane end‐tidal concentration increased/decreased by 50% in response to 25% change in baseline BP or HR. Fentanyl 1 µg/kg (to a maximum of 4 µg/kg) with increase of propofol. Intraoperative muscle relaxation maintained with vecuronium. Isoflurane discontinued 5 minutes before end of surgery, N2O and O2 continued until end of surgery. Postoperative pain management with IV morphine as required Other information: premedication etc. same as TIVA group |
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Outcomes |
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Notes |
Funding/declarations of interest: not reported Study dates: not reported |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Use of a computer‐generated random number list |
Allocation concealment (selection bias) | Unclear risk | No details |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Not feasible to blind anaesthetists to intervention groups |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Discharge from the PACU was assessed by a blinded independent investigator. Study authors do not report whether assessment of hypotension was done by a blinded investigator |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No apparent loss of study participants |
Selective reporting (reporting bias) | Unclear risk | Study authors do not report clinical trials registration. Not feasible to judge risk of selective outcome reporting |
Other bias | Low risk | N2O in O2 used in both groups in addition to other agents. However, unlikely to affect results. |