Abstract
Background: Day care surgeries require anesthetic techniques that ensure rapid induction, stable intraoperative conditions, and early postoperative recovery for same-day discharge. Both Total Intravenous Anesthesia (TIVA) and inhalational anesthesia are commonly used methods, but their comparative effects on recovery profiles are still debated.
Objective: This study aimed to compare the recovery characteristics of TIVA versus inhalational anesthesia in patients undergoing elective day care surgeries.
Methods: A prospective, randomized controlled trial was conducted at the Department of Anesthesiology, Chaudhary Muhammad Akram (CMA) Hospital, from January to June 2025, involving 100 adult patients (ASA I–II), aged 18–55 years, scheduled for elective day care surgeries. The participants were randomly assigned to two groups: Group T (n = 50), which received total intravenous anesthesia (TIVA) with propofol infusion (100–150 µg/kg/min) and fentanyl supplementation, and Group I (n = 50), which received inhalational anesthesia with sevoflurane (1–1.5 MAC) and nitrous oxide in oxygen. Standard monitoring and analgesic protocols were followed for all patients. Recovery was evaluated using the Modified Aldrete Score, and the time to eye opening, orientation, ambulation, and readiness for discharge were measured.
Results: Both groups were comparable in demographic characteristics. The mean time to eye opening was 6.4 ± 1.2 minutes in Group T versus 4.8 ± 1.0 minutes in Group I (p < 0.01), indicating faster emergence in inhalational anesthesia. However, orientation time was significantly shorter in Group T (8.2 ± 1.4 minutes) compared to Group I (11.6 ± 2.0 minutes, p < 0.001). Readiness for discharge (Modified Aldrete Score ≥ 9) was achieved earlier in the TIVA group (58 ± 8 minutes) versus the inhalational group (72 ± 10 minutes, p < 0.001). Incidence of PONV was 8% in TIVA versus 28% in inhalational anesthesia (p = 0.01).
Conclusion: Although inhalational anesthesia allowed quicker emergence from anesthesia, TIVA provided faster cognitive recovery, earlier discharge readiness, and significantly lower PONV. Therefore, TIVA is a superior choice for day care surgeries to ensure patient comfort and early discharge.