Comparison between propofol-remifentanil total intravenous anaesthesia and desflurane-remifentanil balanced anaesthesia with regard to post-anaesthetic functional recovery measured with the Quality of Recovery-40 questionnaire on the day of vitrectomy

Abstract

Background: Total intravenous anaesthesia (TIVA) and inhalation anaesthesia are now commonly and safely used for general anaesthesia in outpatient surgery. Few studies have examined whether the TIVA has an advantage related to the functional recovery on the day of surgery. This study compared the degree of functional recovery following TIVA and inhalation anaesthesia using the Quality of Recovery-40 questionnaire (QoR-40) on the day of vitrectomy under general anaesthesia. Methods: In this prospective, double-blinded, randomized study, 83 patients (20-80 years old) undergoing elective vitrectomy were randomized into two groups. The PRO group received effect-site target-controlled infusion (TCI) of propofol and remifentanil and the DES group received desflurane inhalation with effect-site TCI of remifentanil. Functional recovery at 6 h after surgery was assessed using the QoR-40. Other data such as emergence time, nausea/vomiting, and additional use of analgesic agent for agitation rescue or antiemetic drug in the post-anaesthesia care unit were collected. Results: In the PRO group, the QoR-40 score on the day of surgery was significantly higher (P=0.033) than in the DES group (181.0 vs 169.5 in PRO 2 and DES groups, respectively). In particular, PRO group had significantly higher scores for physical comfort and physical independence dimensions. The amount of remifentanil administered was significantly higher and the emergence time was significantly longer in PRO group. However, there were no significant differences in other complications between the two groups. Conclusion: TIVA showed better results in the quality of recovery on the day of surgery than inhalation anaesthesia.