Study Title

A randomized controlled study to compare the efficacy of Total Intravenous Anaesthesia TIVA using Propofol versus Balanced Anaesthesia using Sevoflurane on recovery profiles and hemodynamic stability in patients undergoing laparoscopic cholecystectomy

Background and Justification

Laparoscopic cholecystectomy is a common minimally invasive procedure yet it presents unique physiological challenges including hemodynamic fluctuations due to pneumoperitoneum and a high incidence of postoperative nausea and vomiting PONV While Sevoflurane is a standard inhalational agent known for its titratability Propofol based TIVA is theorized to offer superior hemodynamic stability and a smoother clearheaded recovery with reduced PONV This study aims to provide evidence on which technique optimizes patient outcomes in the perioperative period

Objectives

Primary To compare the recovery profile emergence time extubation time and cognitive recovery between the TIVA and Sevoflurane groups

Secondary To evaluate and compare hemodynamic changes Heart Rate Mean Arterial Pressure at key intervals induction intubation pneumoperitoneum and extubation

Tertiary To assess the incidence of postoperative side effects specifically PONV and shivering

Methodology

Study Design Prospective Randomized Controlled Trial RCT

Participants Adults eg ASA physical status I and II scheduled for elective laparoscopic cholecystectomy

Intervention Group A Total Intravenous Anaesthesia TIVA using Propofol infusion

Comparator Group B Balanced General Anaesthesia using Sevoflurane with an oxygen nitrous oxide or air mix

Standardization Both groups will receive standardized premedication analgesia eg Fentanyl and neuromuscular blockade

Expected Outcome

The study seeks to determine if Propofol based TIVA provides a more stable hemodynamic course during the stress of CO2 insufflation and results in a faster more comfortable recovery compared to Sevoflurane based inhalation anesthesia