To Compare Propofol and Sevoflurane for Maintenance of Anaesthesia on Recovery Characteristics and Cognitive Functions: A Randomised Control Trial
Dr. Hardeep Bariar,
Associate Professor, Department of Anaesthesia, Government Medical College, Patiala, Punjab, India.
Introduction: Laparoscopic Cholecystectomy is one of the most commonly performed surgery. Though cognitive dysfunction is less commonly seen, it is one of the most distressing post-operative complication.
Aim: To compare the effects of sevoflurane and propofol infusion for maintenance of anaesthesia on recovery characteristics and cognitive functions in patients undergoing laparoscopic cholecystectomy.
Materials and Methods: After approval from ethical committee, 80 patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were randomly divided into two groups to receive either intravenous infusion of propofol (group A) or sevoflurane inhalation (group B) for maintenance of anaesthesia. Time to spontaneous breathing, eye opening, response to commands, time to extubation, time to achieve aldrete score >9 were recorded. Cognitive functions were recorded by using Rivermead behavioural memory test, California verbal learning test and by asking the name of surgeon and anaesthesiologist, both preoperatively and postoperatively. Descriptive statistics were done for all data and suitable statistical tests of comparison were done. Continuous variables were analysed with unpaired t-test and Mann Whitney U-test. Categorical variables were analysed with Chi-square test.
Results: Haemodynamic parameters like Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) were comparable in both the groups. Though there were slight variations in HR and MAP at some time intervals but patients in both the groups were haemodynamically stable throughout the surgery. Emergence and recovery was significantly faster after maintenance with sevoflurane than propofol. Cognition was better in sevoflurane group than propofol group two hours postoperatively.
Conclusion: Sevoflurane might be considered as a useful alternative to propofol in providing anaesthesia in laparoscopic cholecystectomies, especially in patients where rapid emergence and recovery of cognitive function are very much desired.