RECOVERY OUTCOMES IN PATIENTS UNDERGOING NON-ABDOMINAL SURGERIES: A PROSPECTIVE OBSERVATIONAL STUDY COMPARING ITIVA-GUIDED PROPOFOL INFUSION (SCHNIDER MODEL) WITH MANUAL INFUSION

Abstract

Background:
Total intravenous anesthesia (TIVA) with propofol is widely used for general anesthesia. The iTIVA application, utilizing the Schnider pharmacokinetic model, allows individualized dosing based on patient-specific parameters. This study compared recovery outcomes of propofol delivered via iTIVA versus conventional manual infusion in patients undergoing elective non-abdominal surgeries.

Methods:
In this prospective observational study, 52 ASA I–II patients aged 18–65 years undergoing elective non-abdominal surgeries under general anesthesia were enrolled. Patients were allocated into two groups: Group A (n = 26) received propofol via iTIVA (Schnider model), and Group B (n = 26) received manual infusion. Primary outcome was time to eye opening after discontinuation of propofol. Secondary outcomes included time to obey verbal commands, time to extubation, total propofol consumption, and hemodynamic stability. Data were analyzed using appropriate statistical tests, with p< 0.05 considered significant.

Results:
Time to eye opening was significantly shorter in the iTIVA group compared to the manual infusion group (6.8 ± 1.2 vs. 9.4 ± 1.6 min, p< 0.001). Similar trends were observed for time to obey verbal commands (7.5 ± 1.4 vs. 10.2 ± 1.9 min, p< 0.001) and time to extubation (8.0 ± 1.5 vs. 11.0 ± 2.0 min, p< 0.001). Total propofol consumption was significantly lower in the iTIVA group (540 ± 75 mg) than in the manual infusion group (620 ± 90 mg, p = 0.002). Mean arterial pressure and heart rate were comparable between groups, but the number of hemodynamic variability episodes was lower with iTIVA (1.2 ± 0.6 vs. 2.1 ± 0.8, p = 0.01).

Conclusion:
Propofol administration via iTIVA using the Schnider pharmacokinetic model resulted in faster recovery, lower drug consumption, and fewer hemodynamic fluctuations compared to manual infusion in non-abdominal surgeries. Automated PK-guided delivery may improve anesthetic precision and postoperative recovery profiles.