AUTHOR=Shu Zhuolin , Lin Tiancheng , Xu Dingchen , Zheng Shuyuan 

TITLE=Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1382724

DOI=10.3389/fmed.2024.1382724

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>This study aimed to evaluate and compare the effects of sevoflurane + remifentanil (Sev + Rem) and propofol + remifentanil (Pro + Rem) on the postoperative recovery quality of patients undergoing laparoscopic bariatric surgery to determine which anesthesia regimen provides a better overall recovery experience.</p></sec><sec id="sec2"><title>Methods</title><p>Sixty patients were divided into two groups based on the treatments they underwent: Sev + Rem (<italic>n</italic> = 30) and Pro + Rem (<italic>n</italic> = 30). The Sev + Rem group received sevoflurane inhalation (0.5%, increasing to 0.5–4%) and remifentanil via target-controlled infusion. The Pro + Rem group received propofol [4–8 mg/(kg·h)] and remifentanil via target-controlled infusion. Anesthesia depth was maintained at a bispectral index of 40–60 in both groups. Perioperative data, hemodynamic parameters, and postoperative recovery quality were assessed.</p></sec><sec id="sec3"><title>Results</title><p>Compared to the Pro + Rem group, the dose of remifentanil in the Sev + Rem group was significantly lower (1693.67 ± 331.75 vs. 2,959 ± 359.77, <italic>p</italic> &lt; 0.001), the proportion of patients used norepinephrine was markedly higher [16 (53.33) vs. 8 (26.67), <italic>p</italic> = 0.035], and the time of extubation was earlier (356.33 ± 63.17 vs. 400.3 ± 50.11, <italic>p</italic> = 0.004). The Hemodynamic results showed the HR in the Sev + Rem group was faster than that in the Pro + Rem group at the beginning of surgery and 1 h post-surgery (67.37 ± 4.40 vs. 64.33 ± 4.44, <italic>p</italic> = 0.010, 69.07 ± 4.23 vs. 66.40 ± 5.03, <italic>p</italic> = 0.030). In regard to the assessment of postoperative recovery quality, the emotional state scores in the Sev + Rem group were significantly lower than the Pro + Rem group (36.83 ± 2.79 vs. 39.50 ± 4.64, <italic>p</italic> = 0.009).</p></sec><sec id="sec4"><title>Conclusion</title><p>The two anesthesia modalities (Sev + Rem and Pro + Rem) have their advantages and disadvantages for patients undergoing laparoscopic bariatric surgery and have comparable effects on postoperative recovery quality.</p></sec>