THE EFFECT OF GENDER ON RATE OF EMERGENCE FROM TOTAL INTRAVENOUS ANAESTHESIA IN OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITALS COMPLEX, ILE-IFE.

Abstract

BACKGROUND: The rate of emergence from general anaesthesia has
always been an interesting subject to the anaesthetist. The effect of
gender as an independent factor influencing recovery is known to be
masked by several other factors including drug dosage, time of
administration, age, liver and renal diseases. This double blinded
study was carried out to ascertain the role gender plays in emergence
from Intravenous Propofol general anaesthesia.
AIMS AND OBJECTIVES: This study was undertaken to ascertain
the rate of emergence from Intravenous Propofol general anaesthesia
among male and female elective general surgery patients and to
determine any significant difference in the rate of emergence from
the effects of Intravenous Propofol general anaesthesia between the
sexes. It was also carried out to identify other possible modifiable
factors that may be responsible for the rate of emergence from
Intravenous Propofol general anaesthesia among both sexes.
METHODOLOGY: One hundred and twenty ASA I and II patients,
aged 18-70 years undergoing elective general surgical procedures
under general anaesthesia lasting between 60 to 120 minutes (60
males and 60 females) were included in the study. The rate of
recovery was observed continuously after the termination of
anaesthesia. Wake up events were timed and recorded by
anaesthetists not involved with administration of the anaesthesia.
RESULTS: The time from end of anaesthesia to spontaneous eye
opening was 5.56±1.56mins for women versus 9.36±2.35mins in
men(P=0.000), eye opening to verbal commands was 4.58±1.52mins
for women versus 8.62±2.89mins in men(P=0.000) , responding to
verbal commands was 6.19±1.68mins for women versus
10.22±2.80mins in men(P=0.000), moving limbs to adequate muscle
power was 7.14±1.66mins for women versus
11.05±2.32mins(P=0.000) and time of extubation was
7.92±1.77mins for women versus 14.07±16.29mins(P=0.005) in
men. Premenopausal women also emerged faster than
postmenopausal women.
CONCLUSION: Gender is an important factor for emergence from the
effects of Propofol general anaesthesia as women emerged faster than men from Propofol general anaesthesia provided by TIVA.
Pharmacokinetic and pharmacodynamic factors as well as hormonal
influence may explain this difference in wake up time abetween
males and females.