Comparison of Propofol and Isoflurane Effect on Hemorrhage during Spine Surgery

Introduction & By prevention of bleeding during spine surgery, we could provide suitable field for the surgeon and also reduce blood loss and the need for transfusion. The purpose of this study was to compare the effects of intravenous administration of propofol and isoflurane for anesthesia maintenance on the amount of blood loss and hemodynamic status during the surgery. In this clinical trial single blind study, 100 patients undergoing spinal surgery with ASA I were randomly assigned in two groups P and I; in group P we used intra-venous propofol (100-200? /kg/min) plus nitrous oxide 50% (50 patients) and in group I we applied isoflurane, (MAC 1.5-2) plus nitrous oxide 50% (50 patients) for maintenance of an-esthesia. For determining and comparing blood loss in each group, total volume of blood loss during surgery was determined by weighting of blood on gausses and volume of blood in suction bottle. The amount of hemoglobin, the need for blood transfusion and satisfaction of surgeon from operative field during surgery were also assessed. Mean arterial pressure and heart rate were measured every 5 minutes intra operative and were compared in the two groups. The data was analyzed by SPSS and t-test. The total volume of blood loss in propofol and isoflurane groups was 352.7± 303.5 and 450.48±321.8 ml, respectively. Total blood loss, and blood loss per min was significantly lower in the propofol group and isoflurane group (P=0.049, P=0.015). Surgeon satisfaction with bleeding of surgery field based on the Boezzart scale was higher in the propofol group. Decrease in hemoglobin concentration and hematocrit were less in the propofol group com-pared to the isoflurane group. Mean arterial pressure during surgery with the propofol group was 85.71±9.7 versus 80.25±8.04 mmHg in the isoflurane group, which was significantly lower in the isoflurane group (P=0.003). The difference between the heart rate during surgery and the need for blood transfusion in the two groups was not significant. In view of the decreased amount of blood loss and hemoglobin reduction, as well as improving surgical field, intravenous propofol is preferred to isoflurane for anesthesia maintenance during spine surgery. So, we recommend the maintenance of anesthesia with intravenous propofol during spine surgery.