Comparison of Propofol–Dexmedetomidine-Based Intravenous and Sevoflurane-Based Inhalational Anesthesia in Patients Undergoing Modified Radical Mastectomy

BACKGROUND AND AIM: Total intravenous anesthesia (TIVA) has proven advantage over inhalational anesthesia in terms of stable hemodynamic, eco-friendly, and good recovery profile, but apprehension regarding adequate depth of anesthesia and intraoperative recall is still pertaining. This study aims to compare propofol–dexmedetomidine-based TIVA with sevoflurane-based inhalational anesthesia in modified radical mastectomy in terms of depth of anesthesia, intraoperative recall, recovery profile, and hemodynamic status. SETTINGS AND DESIGN: This prospective randomized controlled study was conducted at a tertiary care center over a time frame of 1 year. METHODOLOGY: In this randomized controlled study, 100 patients were randomly distributed into two groups: TIVA (Group T) and inhalational anesthesia (Group I). Group T patients received injection dexmedetomidine: 1 μg.kg(−1) over 10 min followed by 0.7 μg.kg(−1).h(−1) and injection propofol: 25–100 μg.kg(−1).min(−1). Ventilation was maintained with oxygen–air gas flow. In Group I, patients were ventilated with nitrous oxide–oxygen (50:50) and sevoflurane. Rest of anesthesia for both the groups was same. Primary objective was to achieve adequate depth of anesthesia as monitored by intraoperative bispectral index value (BIS, 40–60). Hemodynamic variables, recovery profile, and amount of individual anesthetic agent consumed were recorded for comparison between two groups. For comparison of scale variables between two groups, independent sample t-test for significant difference between two sample means has been followed. RESULTS: Intraoperative BIS and hemodynamic variables were comparable (P > 0.05). Emergence time was 5.10 min in the TIVA group versus 8.38 min in the inhalational group (P = 0.00). Modified Aldrete score was comparable in two groups (P > 0.05). Cost of TIVA agents consumed per patient was 40% lesser than inhalational agents. CONCLUSION: TIVA maintains adequate depth of anesthesia along with stable hemodynamic and good recovery profile, at low cost in an eco-friendly manner.