Comparison of Monitored Anesthesia Care with Target-Controlled Infusion and Sevoflurane Mask Anesthesia for Outpatient Gynecologic Surgery: A Single-Center Prospective Randomized Controlled Study

TL;DR

This study compares two anesthesia methods for outpatient gynecologic surgery, finding differences in recovery time and patient satisfaction.

Contribution

The study provides new comparative data on recovery profiles and respiratory safety between TCI and sevoflurane anesthesia in outpatient gynecologic surgery.

Findings

Sevoflurane anesthesia resulted in faster eye opening compared to TCI.

TCI provided higher patient satisfaction but increased the risk of respiratory depression.

Both anesthesia methods were found feasible for outpatient gynecologic surgery.

Abstract

Background and Objectives: Rapid recovery and patient comfort are key goals in ambulatory surgery. Although sevoflurane anesthesia is widely used, target-controlled infusion (TCI) with propofol and remifentanil has gained attention for its potential benefits. However, comparative data regarding recovery profiles and respiratory safety remain limited. Materials and Methods: In this prospective randomized controlled trial, 51 ASA I–II patients undergoing outpatient gynecologic surgery were assigned to either a TCI group (n = 25) or an inhalation mask (IM) group using sevoflurane and nitrous oxide (n = 26). Primary outcomes included time to postanesthesia care unit (PACU) discharge readiness and patient and surgeon satisfaction. Secondary outcomes included eye-opening time, anesthesia duration, PACU stay, and respiratory adverse events. Results: Time to Aldrete score ≥9 did not differ significantly between groups (p = 0.697). The IM group demonstrated faster eye opening (p = 0.002), while patient satisfaction was higher in the TCI group (p < 0.001). Surgeon satisfaction favored the IM group (p = 0.035). Respiratory depression occurred more frequently in the TCI group (28.0% vs. 0%, p = 0.012). Conclusions: Sevoflurane anesthesia allowed faster emergence, whereas TCI provided greater patient satisfaction but increased respiratory risk. Both techniques are feasible for ambulatory gynecologic surgery when appropriately selected. Trial registration: This study was retrospectively registered at the Clinical Research Information Service (CRIS), Republic of Korea (KCT0011352).

Figures