Abstract

Emergence from general anaesthesia with long duration use of inhalational agents like Sevoflurane is often associated with turbulent emergence. A subhypnotic dose of propofol (0.5mg/kg) given at the time of skin closure is known to be associated with a faster, clearer headed recovery, with adequate anxiolysis and anti-emesis. Methodology: This was a Prospective single-blinded Randomized controlled study carried out at Department of anaesthesiology, Nizam’s institute of medical sciences (NIMS), India between March 2021 to February 2022. After ethics committee approval, this prospective randomised controlled single blinded study was carried out with 50 adult (18-60) patients, of either gender, posted for elective surgeries under general anaesthesia with sevoflurane, who were divided into two groups, (Group P n= 25) patients receiving 0.5 mg/kg Propofol IV bolus after discontinuing sevoflurane at the time of skin closure (but no antiemetic) and (Group C n= 25) patients receiving 0.15 mg/kg ondansetron +0.08 mg/kg Dexamethasone IV bolus at the time of skin closure. The parameters observed were Emergence time (min), extubation time (min), mental status, SOMCT score, Aldrete score and incidence of nausea and vomiting at different time intervals in the immediate postoperative period. Results were analysed using paired and unpaired student’s T test and Chi square test. (p<0.05 was significant). Results: The mean emergence time and mean extubation time was seen to be statistically significantly higher in the control group as compared to the propofol group. Postoperative mental status was seen to have higher number of confused and agitated patients in the control group. Patients in propofol group performed better than the control group with respect to short orientation memory concentration test results. Modified Aldretes scores and incidence of Nausea and Vomiting was comparable in both the groups. Conclusion: A subhypnotic dose of propofol (0.5mg/kg), given at skin closure in patients receiving sevoflurane as maintenance agent under general anaesthesia, significantly reduces emergence time, extubation time and also gives a calm, oriented, and clear-headed recovery with lesser incidence of postoperative nausea and vomiting, in the absence of an antiemetic

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