Quality of recovery after anesthesia for patients undergoing laparoscopic surgery: a prospective, controlled, double-blind randomized study comparing total intravenous anesthesia versus desflurane anesthesia -

Background: Fast-track surgery is a multimodal approach to reduce postsurgical organ dysfunction and complications in order to improve patient’s postoperative recovery. The study aimed to compare inhaled anesthesia (IA) and total intravenous anesthesia (TIVA) with regard to quality of recovery, cost-effectiveness, and which anesthetic technique is more suitable for fast-track programs concerning laparoscopic cholecystectomy or pelvic surgery. Methodology: This study was conducted at King Fahd Hospital of the University from December 2019 to March 2020. A total of 50 patients were randomly allocated into two groups; one received IA (desflurane group) and the other TIVA (propofol group). Preoperative and postoperative assessments were carried out using various tools to compare both techniques. Results: The recovery and emergence from anesthesia was more rapid in patients who received IA. The time until patients could answer simple questions was shorter in the IA group. On the contrary, quality of recovery- 15 at 6 hours after surgery was significantly higher in the TIVA group. Similarly, the ability to concentrate and coordinate measured by the Bourdon-Wiersma test was also significantly better in the TIVA group. The ability to retain new facts (anterograde amnesia) as assessed by the picture card test was significantly higher in the TIVA group. Also, postoperative nausea and vomiting were more common with IA. Conclusion: Both IA and TIVA are suitable for fast-track anesthesia. While desflurane group had a rapid emergence and recovery time, the quality of recovery and the ability to concentrate and anterograde amnesia were better in the TIVA group.