TITLE:
Comparison of the Time to Orientation between Combining Propofol with Sevoflurane or Sevoflurane in Patients Undergoing Endoscopic Trans-Nasal Surgery: A Randomized Controlled Trial
AUTHORS:
Narin Plailaharn, Apinya Kittiponghansa, Waroonkarn Mahavisessin, Pichayen Duangthongphon, Thirada Jimarsa, Sangmukda Sara, Lumyai Sabangba, Cattleya Kasemsiri
KEYWORDS:
Propofol, Sevoflurane, Trans-Sphenoidal Surgery, Endoscopic Sinus Surgery, Functional Endoscopic Sinus Surgery (FESS)
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.15 No.8,
August
15,
2025
ABSTRACT: Background: This study investigates whether combining propofol and sevoflurane for anesthesia maintenance results in faster emergence compared to sevoflurane alone in patients undergoing endoscopic trans-nasal surgery. Methods: Thirty-eight patients were randomized to receive either sevoflurane alone (Group S, n = 19) or propofol plus sevoflurane (Group PS, n = 19) targeting a BIS range of 40 - 60. The primary outcome was time to orientation. Secondary outcomes included time to spontaneous ventilation, eye-opening to sound, extubation, hemodynamics, agitation, coughing, analgesic needs, and PONV. Results: The median time to orientation was significantly longer in Group PS (12 minutes, IQR 6-16) compared to Group S (6 minutes, IQR 5-12) (P Conclusion: Using BIS-targeted anesthesia, combining propofol with sevoflurane resulted in a longer time to orientation than sevoflurane alone in patients undergoing endoscopic trans-nasal surgery, particularly when anesthesia exceeded 120 minutes.