Comparison of recovery time with target controlled infusion of propofol with sevoflurane anesthesia using bispectral index monitoring in vitrectomy surgery

Abstract

Background: Rapid recovery after anesthesia is critical and is associated with the anesthetic agents used. The bispectral index (BIS) monitoring to guide anesthetic agents' doses may play a significant role in the recovery time. This study compared recovery time after Target Controlled Infusion (TCI) of propofol with sevoflurane anesthesia by using BIS monitoring during vitrectomy surgery.  Methodology: This was a prospective observational, randomized study on 40 patients aged 18–65 y, physical status ASA I–II, body mass index (BMI) 18–30 kg/m2, who underwent vitrectomy surgery. Subjects were randomly assigned into two groups, Group P – the TCI propofol group, and Group S – the sevoflurane group. Subjects in the Group P received TCI propofol (Schnider), and subjects in the Group S received sevoflurane for anesthesia maintenance, with a targeted BIS score of 40–60. Inj. fentanyl 1 µg/kg was administered if there was an increase in blood pressure, heart rate and/or BIS that could not be overcome by increasing the dose of TCI propofol or sevoflurane. Recovery time was calculated from when the maintenance regimen was stopped until the patient was able to obey simple commands. Recovery time, fentanyl consumption, postoperative agitation, nausea and vomiting incidence were noted and analyzed with SPSS v21.0 for Windows. T–Test or Mann–Whitney U test was performed to analyze the data.  Result: Recovery time in the Group P [11.5 (5–25) min)] was not significantly different from the Group S [9 (4–18) min, p = 0.139]. Total fentanyl consumption was higher in the Group P than in the Group S (1.765 vs. 1.428 µg/kg). The frequency of agitation during recovery was higher in the Group S than in the Group P (30% vs. 20%) Conclusion: There was no significant difference in recovery time between target controlled infusion of propofol and BIS controlled sevoflurane anesthesia in vitrectomy. Total fentanyl consumption was higher in the Group P than in the sevoflurane group. The impact of these anesthetic regimens on postoperative agitation needs further investigation. Key words: Intravenous anesthesia; Bispectral index monitoring; BIS;  Propofol; Sevoflurane; Target Controlled Infusion; TCI; Vitrectomy Citation: Tantri AR, Sukmono RB, Atmadja LS. Comparison of recovery time with target controlled infusion of propofol with sevoflurane anesthesia using bispectral index monitoring in vitrectomy surgery. Anaesth. pain intensive care 2021;25(6):707–712: DOI: 10.35975/apic.v25i6.1689