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

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

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).

Source: Medicina

DOI: 10.3390/medicina62030596

Authors: Jaesuk Kim, Haneul Jeong, So Young Kwon

Institutions: The Catholic University of Korea St. Vincent's Hospital, Catholic University of Korea

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,654