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BioMed Research International
Volume 2018, Article ID 8214651, 5 pages
Clinical Study

Effects of Total Intravenous Anesthesia and Low- and High-Flow Anesthesia Implementation on Middle Ear Pressure

1Department of Anesthesiology and Reanimation, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
2Department of Otorhinolaryngology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
3Department of Anesthesiology and Reanimation, Yıldırım Beyazıt University, Ankara, Turkey

Correspondence should be addressed to Ayca Dumanli Ozcan; moc.liamg@naczoacyard

Received 16 November 2017; Accepted 8 February 2018; Published 10 April 2018

Academic Editor: Joseph F. Buell

Copyright © 2018 Ayca Dumanli Ozcan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The middle ear is an air-filled lacuna in the temporal bone. Inhaled anesthetic agents increase the pressure of this lacuna. Therefore, attention must be paid in choosing not only anesthetic agents but also anesthetic method. Aim. This study compared the effects of high-flow total intravenous anesthesia (TIVA) and low- and high-flow desflurane anesthesia on middle ear pressure. Study Design. Randomized prospective double-blind study. Methods. In this retrospective double-blind study, 90 patients (20–65 years old) scheduled to undergo elective thyroidectomies were divided into three randomized anesthesia groups: high-flow desflurane (Group I), low-flow desflurane (Group II), and high-flow TIVA (propofol, remifentanil) (Group III). The hemodynamic and respiratory parameters and tympanometry were measured before induction (1), 10 minutes after intubation (2), 10 minutes before the end of the operation (3), and 5 (4), 10 (5), 15 (6), and 30 (7) minutes after the operation. Results. No statistically significant differences were found in the age, gender, weight, height, body mass index, surgery duration, and anesthetic duration (). There were no statistically significant differences at 1, 3, 4, 5, 6, and 7 (), but there was a significant difference at 2 (), with Groups II and III having lower pressure than Group I (). Conclusion. The high-flow desflurane group had higher postinduction middle ear pressure values. Therefore, low-flow anesthesia and TIVA can be used more safely in middle ear surgeries, provided that a well-equipped anesthetic device and appropriate monitoring conditions are available.