Comparison of intravenous induction with propofol versus inhalation induction with sevoflurane: A prospective randomized controlled study

Abstract

Background: Propofol is widely used for the induction of anesthesia. Sevoflurane, a popular inhalational induction agent for pediatric patients, may also be used in adults with needle phobias. Aims and Objectives: This study was done to compare the two popular induction agents, namely, propofol and sevoflurane. The speed of achieving the conditions ideal for intubation, in the background of the synergistic action of sevoflurane with vecuronium, the non-depolarizing muscle relaxant was also studied. Materials and Methods: In this prospective randomized controlled study, female patients between 20 and 65 years of age belonging to the American Society of Anaesthesiologists Grade I and II who underwent elective surgeries for breast cancer under general anesthesia were allocated randomly into two groups. Group 1 patients received propofol as the induction agent and in Group 2 sevoflurane was used as the induction agent. Induction with vital capacity breath technique using 8% sevoflurane was compared with standard induction with propofol. Results: It was found that propofol caused a greater drop in blood pressure (BP), although the time for induction was marginally lower (insignificant) with propofol. Sevoflurane potentiated the effect of vecuronium. One case in the sevoflurane group developed laryngospasm and hence was excluded from the study. Three patients in the propofol group had pain on injection. One patient from each group had abnormal transient groaning sound on induction and two patients from sevoflurane group had coughing on induction. Conclusion: Propofol and sevoflurane are equally fast in inducing anesthesia. Sevoflurane potentiates the action of non-depolarizing muscle relaxants when compared to propofol during induction and may be considered as a better option for patients in whom fall in BP is unlikely to be tolerated even for a short period.