Comparison of Total Intravenous Anesthesia and Sevoflurane-Alfentanil Anesthesia for Laparoscopic Cholecystectomy

Background: The aim of this prospective, double-blind randomized study was to compare the clinical properties of sevoflurane- alfentanil with propofol-remifentanil anesthesia in patients undergoing a laparoscopic cholecystectomy. Methods: Forty patients (ASA physical status 1, 2) scheduled for elective surgery received total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-alfentanil. The TIVA group was induced with propofol 5/ml and remifentanil 4.5 ng/ml. The anesthesia was maintained with a continuous infusions of propofol 2.5/ml and remifentanil 3 ng/ml. The sevoflurane-alfentanil group was induced with alfentanil 15/kg and propofol 1.5 mg/kg IV. Maintenance was obtained with 2.0 vol% sevoflurane and a bolus of alfentanil 10/kg IV where needed. Results: There were no significant differences in the systolic and diastolic blood pressure and heart rate between the two groups. There were no significant differences in the time to eye opening, the time to extubation, post-anesthetic recovery room stay time and the incidence of postoperative nausea and vomiting between the two groups. Conclusions: Propofol-remifentanil (TIVA) and sevoflurane-alfentanil both provided satisfactory anesthesia for a laparoscopic cholecystectomy.