Background: Today, approximately 43% of all surgical procedures in Spain are performed on an outpatient basis. To maintain high quality standards, anesthesia in day-case surgery requires a smooth and pleasant induction, rapid recovery and a low incidence of side effects.Two of the most commonly used drugs are propofol and sevoflurane.
The efficacy in day-surgery of sevoflurane or propofol deep sedation associated with the use of supraglottic devices today has been rarely analized. Our aim is to assess whether it is equally effective inhaled sevoflurane vs propofol as an intravenous continuous infusion in day-case surgery without nitrous oxide or opioids administration.
Materials and methods: After local ethics committe approval, written informed consent was obtained from patients over 18 years old included for day-case surgical inguinal hernia repair for this radomized clinical trial. Patients were randomly allocated to propofol (propofol lipuro® 1%, Braun, Spain) or sevoflurane (Sevorane®, Abbott, Spain). After NIBP, ECG and oxymetry monitoring, induction of anesthesia was performed using either sevoflurane 8% (Group S) or 2 mg/kg iv propofol bolus (Group P). A supraglottic device (i-gel®, Intersurgical, UK) was applied to all patients and spontaneus ventilation resumed. Anesthesia was maintained with 2-3% sevoflurane or 2-6 mcg/kg propofol. Pre-incisional field-block with 30 ml 1% mepivacaine was used. At the end of surgery drug administration was stopped and recovery time was measured as time to open eyes when called, or voluntary movement.
Results and discussion:
60 patients were included, 1 patient in the (P) group was excluded for sugical reasons. Many studies show earlier recovery with sevoflurane compared to propofol (1,2). In our study we found similar results when no opioid, nitrous oxide or any other drug was added on either group.
Conclusion: Early recovery was faster with sevoflurane compared to propofol TCI in day-case patients in this study.
1. Anesth Analg 2004; 98:632-41
2. Eur J Anaesth 2012; 29:371-79