Abstract Rationale Early ambulation is a cornerstone of enhanced recovery protocols in thoracic surgery, with potential to reduce postoperative complications and length of stay. Both balanced anesthesia and total intravenous anesthesia (TIVA) are commonly used techniques, but their impact on functional recovery remains unclear. Previous studies have suggested that anesthetic technique may influence postoperative pulmonary function and early recovery milestones, including mobilization (1). This study aimed to compare time to first ambulation following thoracic surgery between patients receiving TIVA and those receiving balanced anesthesia. Methods We retrospectively analyzed 232 adult patients who underwent thoracic surgery between 2022 and 2024. The anesthetic technique was categorized as balanced anesthesia or TIVA. The primary outcome was time to first ambulation, measured in hours after surgery. As the distribution of ambulation times was non-normal (Shapiro-Wilk p 0.01), group comparisons were performed using the Mann-Whitney U test. A p-value 0.05 was considered statistically significant. Results Among 232 patients, 26 (11.2%) received TIVA and 206 (88.8%) received balanced anesthesia. Patients in the TIVA group had a longer median time to ambulation (48.0 hours, interquartile range IQR: 66.0) compared to those in the balanced anesthesia group (24.0 hours, IQR: 31.0). This difference was statistically significant (p = 0.015), indicating delayed mobilization among patients who received TIVA. Conclusions In this cohort, the use of total intravenous anesthesia (TIVA) was associated with delayed postoperative ambulationcompared with balanced anesthesia. These findings suggest that anesthetic strategy may influence early recovery milestones in thoracic surgery and should be considered in perioperative planning. Further prospective studies are warranted to clarify the physiological mechanisms and confirm these associations in larger populations. References: 1. Lee S, Park SY, Lee JG, et al. Effects of inhalation versus total intravenous anesthesia on postoperative pulmonary complications after lung resection: a retrospective observational study. J Chest Surg. 2022;55(3):212-219. doi:10.5090/jcs.21.119 This abstract is funded by: none
Montoya et al. (Fri,) studied this question.