COMPARISON BETWEEN INHALATIONAL ANESTHETIC (SEVOFLURANE) AND INTRAVENOUS ANESTHETIC (PROPOFOL INFUSION) FOR MAINTENANCE OF ANESTHESIA DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
Main Article Content
Keywords
ERCP, sedation, sevoflurane, propofol, Ramsay Sedation Scale, hemodynamic stability
Abstract
Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) requires effective sedation for procedural success and patient safety. Two commonly used anesthetic agents for sedation during ERCP are propofol (intravenous) and sevoflurane (inhalational), each with distinct pharmacologic properties and clinical profiles.
Objective: To compare the efficacy, hemodynamic stability, and sedation depth of sevoflurane and propofol during ERCP procedures.
Methods: A randomized, double-blind clinical trial was conducted at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Eighty-six ASA I–II patients aged 20–60 undergoing ERCP were randomized to receive either sevoflurane (Group A) or propofol (Group B) for sedation. Sedation depth was assessed using the Ramsay Sedation Scale (RSS) at 1, 3, 5, and 10 minutes, alongside continuous monitoring of vital parameters. Data analysis was performed using SPSS v22.
Results: Propofol achieved significantly higher RSS values at all measured time points (p < 0.05), indicating deeper sedation levels compared to sevoflurane. Additionally, patients in the propofol group showed better hemodynamic stability and shorter recovery times. The effect size analysis confirmed a clinically meaningful difference between the two anesthetics.
Conclusion: Propofol infusion provided superior sedation quality, faster onset, better cardiovascular stability, and quicker recovery compared to sevoflurane during ERCP. It is recommended as the preferred anesthetic agent for sedation in ERCP procedures.
Objective: To compare the efficacy, hemodynamic stability, and sedation depth of sevoflurane and propofol during ERCP procedures.
Methods: A randomized, double-blind clinical trial was conducted at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Eighty-six ASA I–II patients aged 20–60 undergoing ERCP were randomized to receive either sevoflurane (Group A) or propofol (Group B) for sedation. Sedation depth was assessed using the Ramsay Sedation Scale (RSS) at 1, 3, 5, and 10 minutes, alongside continuous monitoring of vital parameters. Data analysis was performed using SPSS v22.
Results: Propofol achieved significantly higher RSS values at all measured time points (p < 0.05), indicating deeper sedation levels compared to sevoflurane. Additionally, patients in the propofol group showed better hemodynamic stability and shorter recovery times. The effect size analysis confirmed a clinically meaningful difference between the two anesthetics.
Conclusion: Propofol infusion provided superior sedation quality, faster onset, better cardiovascular stability, and quicker recovery compared to sevoflurane during ERCP. It is recommended as the preferred anesthetic agent for sedation in ERCP procedures.
References
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9. Yoon, S., Lee, K., & Kim, J. (2018). Hemodynamic stability and recovery profiles of propofol vs. sevoflurane in ERCP patients. Anesthesia & Analgesia, 126(3), 765-771
2. El Ahl, M. I. S. (2014). Modified sevoflurane-based sedation technique versus propofol for colonoscopy in geriatric patients. Saudi Journal of Anaesthesia, 8(2), 206–211.
3. Wang, X., & Ji, X. (2020). Sample size estimation in clinical research: From randomized controlled trials to observational studies. Chest, 158(1), S12–S20.
4. Baltacı, B., Başar, H., Akpınar, E., & Başar, M. (2020). Effect of sevoflurane anaesthesia on nasal mask in endoscopic retrograde cholangiopancreatography: A randomized controlled trial. Turkish Journal of Gastroenterology, 31(1), 41–46
5. Dumonceau, J. M., Riphaus, A., Schreiber, F., Vilmann, P., Beilenhoff, U., Aparicio, J. R., ... & Hassan, C. (2015). European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline: Non-anesthesiologist administration of propofol for GI endoscopy. Endoscopy, 47(12), 1175–1189.
6. Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763–1768.
7. Alzanbagi, A. B., Jilani, T. L., Qureshi, L. A., Alzahrani, M. A., & Alharthi, F. S. (2022). Randomized trial comparing general anesthesia with anesthesiologist-administered deep sedation for ERCP in average-risk patients. Gastrointestinal Endoscopy, 96(3), 516–526
8. Triantafillidis, J. K., Merikas, E., & Nikolakis, D. (2021). Sedation in gastrointestinal endoscopy: Propofol versus traditional sedation. World Journal of Gastrointestinal Endoscopy, 13(4), 86-98.
9. Yoon, S., Lee, K., & Kim, J. (2018). Hemodynamic stability and recovery profiles of propofol vs. sevoflurane in ERCP patients. Anesthesia & Analgesia, 126(3), 765-771
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Published
May 20, 2025
Article Details
How to Cite
Vijai Kumar, Sagar Khurana, Shakil Malik, Syed Muhammed Abbas, Zamir Ahmad, & Qamar Abbas. (2025). COMPARISON BETWEEN INHALATIONAL ANESTHETIC (SEVOFLURANE) AND INTRAVENOUS ANESTHETIC (PROPOFOL INFUSION) FOR MAINTENANCE OF ANESTHESIA DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 1713-1720. https://doi.org/10.53555/93hzsv12
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Author Biographies
Vijai Kumar
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
Sagar Khurana
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
Shakil Malik
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
Syed Muhammed Abbas
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
Zamir Ahmad
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
Qamar Abbas
Department Of Anaesthesia, Sindh Institute Of Urology And Transplantation Karachi, Pakistan
How to Cite
Vijai Kumar, Sagar Khurana, Shakil Malik, Syed Muhammed Abbas, Zamir Ahmad, & Qamar Abbas. (2025). COMPARISON BETWEEN INHALATIONAL ANESTHETIC (SEVOFLURANE) AND INTRAVENOUS ANESTHETIC (PROPOFOL INFUSION) FOR MAINTENANCE OF ANESTHESIA DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 1713-1720. https://doi.org/10.53555/93hzsv12