A Comparison of the Recovery Characteristics of Propofol and Sevoflurane Anesthesia under Bispectral Index System Monitoring

Background: This prospective, double-blind randomized study was performed to compare the characteristics of recovery after general anesthesia induced by target-controlled propofol and sevoflurane. Methods: Sixty, ASA class 1 or 2 female patients scheduled for an elective total abdominal hysterectomy were randomly allocated to two groups of 30; i.e. Propofol or Sevoflurane groups. General anesthesia was induced using propofol plus a fentanyl bolus (1/kg), and maintained with 66% nitrous oxide and either propofol infusion or sevoflurane inhalation. Anesthetic depth was controlled under bispectral index (BIS) monitoring: propofol and sevoflurane concentrations were adjusted to achieve target BIS values, and were between 40-60 during surgery and 60-70 during the final 15-20 minutes. The two anesthetic agents were discontinued following subcutaneous layer closure. After skin closure, the patients were ventilated manually with 100% oxygen until extubation. Patients were evaluated in terms of level of consciousness and side effects at the end of anesthesia and at 5, 15, 30 and 120 min after anesthesia. Results: There were no significant differences in recovery times. The incidences of side effects were similar in the two groups, though the incidence of postoperative nausea was higher in the sevoflurane group. Conclusions: These results suggest that sevoflurane inhalation anesthesia has an emergence similar to that of propofol, except for a higher incidence of postoperative nausea.