Propofol vs Sevoflurane in General and Cognitive Recovery from Anaesthesia in Day Care Surgery- A Randomised Clinical Trial

Abstract

Introduction: Rapid emergence from anaesthesia and postoperative recovery of cognitive function is one of the most important requirements of a day care surgery. Propofol is a near-ideal intravenous anaesthetic agent for day care surgeries due to its pharmacological properties. Similarly, amongst inhalational anaesthetic agents, sevoflurane is the preferred agent due to low blood-gas solubility. Aim: To evaluate sevoflurane and propofol for general and psychomotor recovery profile in day care anaesthesia techniques. Materials and Methods: This randomised clinical trial was conducted at GGS Medical College and Hospital, Faridkot, Punjab after getting approval by Institutional Ethical Committee. A total of 70 American society of Anaesthesiologists’ (ASA) Grade I and II patients aged 18-60 years, scheduled to undergo elective day care surgery under general anaesthesia were enrolled. In group A (n=35) anaesthesia was induced with propofol 2 mg/kg intravenously and maintained with variable-rate propofol infusion. In group B (n=35) anaesthesia was induced with sevoflurane 8% and maintained with sevoflurane. In both the groups general {mean time to remove Laryngeal Mask Airway (LMA), emergence, time to responds to commands, mean orientation time} and psychomotor recovery profile was evaluated using unpaired student’s t-test and Chi-square test. Results: Mean Time to remove LMA in Group B was earlier being 5.30±1.23 minutes vs 8.65±2.40 minutes in group A (p<0.001). Mean emergence time in Group B was 5.83±1.23 minutes and in Group A was 8.87±2.42 minutes (p<0.001). Time to respond to commands in Group B was 6.81±1.39 minutes and in Group A was 10.01±2.52 minutes (p<0.001). Mean Orientation time in Group B was 7.15±1.53 minutes and in Group A was 10.76±2.61 minutes (p<0.001). Psychomotor recovery was also faster with sevoflurane as compared to propofol. Conclusion: Both sevoflurane and propofol are useful agents for day care surgery. Sevoflurane provides a rapid return of psychomotor and cognitive ability as compared to propofol.