A prospective, randomised trial comparing the quality of recovery between full inhalation anaesthesia and total intravenous anaesthesia post gynaecological surgery

Background: Assessing the quality of recovery (QOR) after open gynaecological surgery done under general anaesthesia (GA) is one of the methods to evaluate anaesthesia outcomes effectively. GA can be administered as full inhalation anaesthesia (FIA) and/or total intravenous anaesthesia (TIVA). Studies have not compared QOR between TIVA and FIA in this cohort. Our study aims to compare the effect of TIVA and FIA on postoperative recovery of patients assessed by the Quality of Recovery-40 (QOR-40) questionnaire. Methods: One hundred and eight consenting adult patients posted for open gynaecological surgeries under GA were randomly allocated to Sevoflurane-based full inhalation anaesthesia (Group FIA) or propofol-based TIVA (Group TIVA). The primary outcome was comparing the QOR-40 score on the first postoperative day (POD1). Comparing QOR-40 on POD2, extubation time, and Modified Observer’s Assessment of Alertness/Sedation Scale (MOAA/S) score after extubation were the secondary outcomes. Epidural analgesia was provided throughout the study period in both groups. Results: The mean QOR-40 score in group FIA was not significantly different from that in group TIVA (171.44 ± 7.43 vs. 171.37 ± 7.48; P = 0.951). However, within the group, there was a significant reduction in scores in POD1 ( P < 0.001) and POD2 ( P < 0.001) from pre-operative values. There was no significant difference in extubation time ( P = 0.207) and MOAA/S score ( P = 0.548) between the groups. Conclusion: Our study found no significant difference in QOR-40 score, extubation time, and MOAA/S score between group FIA and TIVA.