Major abdominal surgeries are associated with significant physiological stress and require anesthesia techniques that provide stable hemodynamics, adequate depth of anesthesia, rapid recovery, and minimal postoperative adverse effects. Target controlled infusion systems use pharmacokinetic models to maintain a desired plasma or effect site drug concentration, allowing more precise titration of anesthetic agents compared to conventional manual infusion or inhalational anesthesia.

In this prospective clinical study, adult patients scheduled for elective major gastroenterology procedures under general anesthesia will receive anesthesia maintained with target controlled infusion guided Propofol and Remifentanil infusions according to standard institutional practice. Standard monitoring will be used, and intraoperative parameters such as heart rate, blood pressure, oxygen saturation, end tidal carbon dioxide, and anesthetic drug consumption will be recorded at predefined intervals. The need for additional vasoactive drugs and intraoperative complications will also be documented.

Recovery characteristics will be assessed using objective measures including time to spontaneous breathing, extubation time, response to verbal commands, orientation. Total anesthetic drug consumption will be calculated, and postoperative side effects such as postoperative nausea and vomiting and other adverse events will also be noted. Postoperative outcomes such as pain scores, requirement of rescue analgesia, sedation level, and any respiratory or cardiovascular adverse events will be noted during the immediate postoperative period.

The results of this study will help determine whether target controlled infusion total intravenous anesthesia with Propofol and Remifentanil provides improved recovery quality and perioperative stability in major gastroenterology surgeries, potentially contributing to enhanced recovery protocols and better patient safety.