The increasing number of outpatient surgery which requiring the rapid, smooth induction of anesthesia with rapid recovery may lead to the use propofol or sevoflurane. Our objective was to compare the hemodynamic responses and recovery profiles obtained by sevoflurane inhalation with propofol infusion using a laryngeal mask airway (LMA) in an ambulatory setting.

Forty patients undergoing knee arthroscopic surgery were randomized into two groups. The laryngeal mask airway insertion was accomplished by using the voluntary maximal vital capacity breathing method (VCB) with sevoflurane 7% in nitrous oxide 50% (sevoflurane group) or by the infusion of propofol (target: 7µg/ml) (propofol group). Under BIS monitoring (40-60), anesthesia was maintained by sevoflurane (2-3%) or propofol (range of 3.7-4.2µg/ml) with spontaneous respiration. Time to loss of consciousness (LOC) and LMA insertion from induction of anesthesia, hemodynamic responses, end tidal CO2, and recovery profiles were evaluated.

The mean time to LOC and to successful LMA insertion were similar in the groups. Hemodynamic responses in the sevoflurane group were not significantly different from those of the propofol group. However, in both groups, systolic and diastolic blood pressure were lower at the time of loss of consciousness and 5 min of after LMA insertion versus preinduction and LMA insertion values (P<0.05). Heart rate was significantly lower in the propofol group (P<0.05). After cessation of anesthesia, hemodynamic responses and to the time for LMA removal or to the time for responding to a verbal command were similar in both groups.

Sevoflurane inhalation and propofol infusion anesthesia with spontaneous respiration provided comparable conditions for outpatient surgery.