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. 2018 Aug 21;2018(8):CD012317. doi: 10.1002/14651858.CD012317.pub2

Luntz 2004.

Methods RCT, parallel design, single‐centre
Participants Total number of randomized participants: 96
Inclusion criteria
  1. Scheduled for elective, unilateral ophthalmic surgery, ≥ 65 years of age, ASA I to III


Exclusion criteria
  1. Obvious cardiovascular complaints (NYHA III to IV)

  2. Previous adverse reactions to one of the study drugs

  3. Participating in another study

  4. History of GA in last 3 months

  5. Less than 60% vision in the contralateral eye


Type of surgery: ophthalmic surgery
Baseline characteristics
TIVA group
  1. Age, (assumed) mean (SD): 74 (± 7) years

  2. Gender: not reported

  3. ASA grade: not reported


Inhalational maintenance group (propofol/sevoflurane)
  1. Age, (assumed) mean (SD): 76 (± 6) years

  2. Gender: not reported

  3. ASA grade: not reported


Inhalational maintenance group (total sevoflurane)
  1. Age, (assumed) mean (SD): 77 (± 7) years

  2. Gender: not reported

  3. ASA grade: not reported


Note: table of baseline characteristics is not reported. Study authors report "There were no significant differences between the patient groups with regard to age, gender, height, weight and ASA physical status"
Country: Germany
Setting: hospital
Interventions TIVA group
Participants: n = 32; 0 losses
Induction details: propofol 2 mg/kg, continuous infusion of remifentanil 20 µg/ kg/hour. Atracurium 0.3 mg/kg to 0.5 mg/kg
Maintenance details: continuous infusion of propofol 4 mg/kg/hour to 8 mg/kg/hour. Remifentanil at 10 µg/kg/hour
Inhalational maintenance group (propofol/sevoflurane)
Participants: n = 32; 0 losses
Induction details: propofol 2 mg/kg, continuous infusion of remifentanil 20 µg/ kg/hour. Atracurium 0.3 mg/kg to 0.5 mg/kg
Maintenance details: sevoflurane end‐tidal concentration 0.6% to 1.2%. Remifentanil 10µg/kg/hour
Inhalational maintenance group (total sevoflurane)
Participants: n = 32; 0 losses
Induction details : continuous infusion of remifentanil 20 µg/ kg/hour. Atracurium 0.3 mg/kg to 0.5 mg/kg. After 1 minute pre‐oxygenation, vaporizer adjusted stepwise up to 8% sevoflurane until eyelash reflex was abolished, then reduced to 5%
Maintenance details: sevoflurane end‐tidal concentration 0.6% to 1.2%. Remifentanil 10µg/kg/hour
Outcomes
  1. Clinical outcomes (MAP and hypotension, shivering, pain, PONV, duration of induction and maintenance of anaesthesia, and time to emergence)

  2. Psychomotor recovery

  3. Participant satisfaction

  4. Cost analysis

Notes Funding/declarations of interest: supported in part by a grant from Abbott Laboratories, Wiesbaden, Germany
Study dates: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Use of computer‐generated randomization
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 group
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Relevant reported outcome is for hypotension. Study authors do not report who collected this data and whether they were blinded
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 Baseline characteristics table not reported, but study authors reported no differences. No other sources of bias identified