THE COMPARATIVE EFFECTS OF SEVOFLURANE VERSUS PROPOFOL IN THE INDUCTION AND MAINTENANCE OF ANESTHESIA IN ADULT PATIENTS

A randomized, prospective study was performed at four institutions to compare anesthetic induction, maintenance, and recovery characteristic s between sevoflurane- and propofol-based anesthesia in 186 ASA physic al status I and II patients undergoing elective surgical procedures of 1-3 h. Group 1 (n = 93) patients received sevoflurane-nitrous oxide f or both induction and maintenance of anesthesia while Group 2 (n = 93) received propofol-nitrous oxide anesthesia. Induction of anesthesia a nd tracheal intubation times were significantly shorter with propofol (2.2 +/- 0.2 min, 5.1 +/- 0.3 min, respectively) than with sevoflurane (3.1 +/- 0.2 min, 7.2 +/- 0.3 min, respectively). Emergence times aft er sevoflurane (8.8 +/- 1.2 min) were significantly shorter than with propofol (13.2 +/- 1.2 min). Overall frequency of complication-free in duction, maintenance, and emergence did not differ between the two ane sthetic groups. However, side effects involving airway excitement were more prevalent during mask induction with sevoflurane as compared to propofol. Patients in the sevoflurane group were oriented and required postoperative analgesia much earlier than those who received propofol . Both groups were hemodynamically stable throughout the study period. The incidence of postoperative nausea, vomiting, and pain-discomfort scores were similar between the two groups. Urinary specific gravity d ecreased in the sevoflurane-treated group while serum creatinine and u rinary pH were unchanged from preoperative values in both groups. Sevo flurane compared favorably with propofol when used for anesthesia for elective procedures of 1-3 h duration.