Comparative Effects of Propofol and Sevoflurane on Postoperative Recovery in Adult Surgical Patients.

Background: Propofol and sevoflurane are the most commonly used maintenance agents for general anesthesia. They have different effects on emergence profile and postoperative nausea and vomiting (PONV) Making optimum use of them is important for an early recovery and efficient turnover of the operation theatre. Aim: the study is to compare early postoperative recovery and PONV after propofol-based and sevoflurane-based general anesthesia in adult patients undergoing elective surgery at a tertiary care center at Udaipur, Rajasthan. Materials and Methods: The present prospective comparative study was conducted from January to June 2025 in the adult patient group of ASA I and II scheduled for a short elective surgery and requiring general anesthesia. Here, 75 adult patients (18 to 60 years) were randomly allocated to receive propofol (Group P, n=38) or sevoflurane (Group S, n=37) for maintenance of anesthesia. Standard and similar regimens for induction, opioids and neuromuscular blockers were used. The early recovery outcomes were time to extubation, eye opening, orientation and attainment of Modified Aldrete score ≥9. The incidence and severity of PONV, need for rescue antiemetic, and VAS-Pain score and need for rescue analgesic were recorded till 24 hours post operatively. The statistical tests used were appropriate and a p<0.05 was considered statistically significant. Results: indicated that baseline demographic and surgical variables were similar between the two groups. Sevoflurane has a much faster extubation (10.9±3.1 vs 12.8±3.4 min; p=0.01), time to eye opening (13.2±3.5 vs 15.6±3.8 min; p=0.006), time to orientation (15.7±4.0 vs 18.9±4.2 min; p=0.003), and time to modified Aldrete score ≥9 (19.8±4.7 vs 22.4±5.1 min; p=0.018). Discharge time from the recovery room was shorter with sevoflurane but statistically not significant. The use of propofol was associated with lower PONV rates at 30 minutes, 6 hours, and 24 hours (e.g. 15.8% versus 32.4% within 24 hours; p=0.09) and with a fewer number of patients requiring rescue antiemetics compared to the typical volatile agent used, although the differences were not statistically significant. Pain scores and the demand for rescue analgesics were alike across groups. Conclusion: In adult elective surgical patients, sevoflurane provided faster early emergence and orientation compared with propofol. On the other hand, propofol demonstrated a trend for lower PONV, with no differences in pain or analgesic use. Either approach is effective and safe. The choice of maintenance agent may be guided by clinical priorities, such as sevoflurane for rapid recovery or propofol to minimize PONV.