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Objective: To compare anesthetic techniques, propofol-TCI, desflurane, and sevoflurane, for better results in terms of postoperative nausea and vomiting (PONV) and extubation times.
Material and Method: The present study was prospective with informed consent from 75 patients, ASA 1-3 scheduled for laparoscopic cholecystectomy, and classified by anesthetic technique into three groups. The patients were induced by propofol target plasma concentration 6 μg/ml in Group P, or 1-2 mg/kg in Group S and Group D, fentanyl 2 μg/kg and vecuronium 0.1 mg/kg followed by propofol 2 to 5 μg/ml in group P, sevoflurane 0.5 to 3% in Group S, and desflurane 2 to 6% in Group D.
Results: The incidence of postoperative nausea and vomiting was least in Group P, both at the PACU (p<0.001) and ward (p = 0.01). Extubation time excluding outlier were Group P 11.17±1.19 minutes, Group D 13.96±1.17 minutes, Group S 11.75±1.34 minutes (p = 0.25). There were no statistical differences in the amount of fentanyl (p = 0.38) and fluid replacements (p = 0.05).
Conclusion: Laparoscopic cholecystectomy under propofol with TCI is one option of anesthetic technique with a significantly lower incidence of PONV compared with both sevoflurane and desflurane otherwise there is no statistical difference in the extubation time. Propofol-TCI technique is suggested for laparoscopic and ambulatory surgery.
Keywords: Laparoscopic cholecystectomy, Propofol, Target-controlled infusion, Postoperative nausea/vomiting, Extubation time