الفهرس 
Introduction
MicrolaryngoscopyOnly 14 pages are availabe for public view
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Abstract
We hypothized that even small endotracheal tube or insufflation catheter have the disadvantage of obscuring the operative field in microlaryngeal surgery. The aim of the study was to compare the effect of tubeless anaesthesia with TIVA using propofol and fentanyl versus general anaesthesia with isoflorane on haemodynamic stability and recovery profile in patient subjected to such surgery. forty patients comprised this study. They were ASA physical status I and II, of either sex, with age ranging from 2050 years. The candidate patients were randomly allocated into two groups, 20 patients in each: <U+25CF> In (TIVA group): Patients received induction dose of 2mg/kg propofol followed by continuous infusion 10mg/kg/hr with intermittent bolus dose of (20mg) propofol at signs of awareness All over the duration of surgery, fentanyl infusion started simultaneously with propofol infusion in a rate 1<U+00B5>gm/kg/hr using syringe type infusion pump.If the patient is desaturated (arterial O2 saturation less than 90%), the surgery was temporarily stopped and oxygenation of the patient by 100% oxygen delivered to the patient by small tube introduced through the opening of the operating laryngoscope near the vocal cords without intubation. <U+25CF> In (Isoflurane group): Patient received induction dose of 2mg/kg propofol , Tracheal intubation was facilitated by intubating dose of succinylcholine (1mg/kg) using a suitable size cuffed endotracheal tube. anaesthesia was maintained by and isoflurane 2%, N2O:O2 of ratio 2:1 and vecronium for muscle relaxation. Intraoperative monitoring included heart rate, mean arterial blood pressure, arterial O2 saturation. All these data were recorded immediately before induction, after induction, and every 5 min. throughout the procedure also, recovery score was assessed at 1min, 10min and 30min postoperatively. There was significant decrease in heart rate in TIVA group till 20min when compared with the basal values and with isoflurane group and also significant increase in the heart rate till 10min in isoflurane group when compared with basal values. There was significant decrease in mean arterial blood pressure till 20min in TIVA group when compared with basal values and with isoflurane group and also significant increase in mean arterial blood pressure till 10min in isoflurane group when compared with basal values. There was significant decrease in arterial oxygen saturation (Sao2) at 5min and 10min in TIVA group when compared with basal values and with isoflurane group. There was a significant increase in recovery score at 10min and 30min in TIVA group when compared basal values and with isoflurane group. We can conclude that propofol fentanyl infusion is better in recovery profile and haemodynamic stability than isoflurane inhalation anaesthesia for microlaryngeal surgery.