COMPARISON BETWEEN INHALATIONAL ANESTHETIC (SEVOFLURANE) AND INTRAVENOUS ANESTHETIC (PROPOFOL INFUSION) FOR MAINTENANCE OF ANESTHESIA DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

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.