Comparison of the effects of different general anesthesia methods on the quality of early postoperative recovery in patients undergoing metabolic bariatric surgery: A randomized controlled trial.

The optimal choice of general anesthesia technique for patients with obesity remains the subject of debate. At present, the anesthesia methods widely applied in clinical settings mainly consist of propofol-based intravenous anesthesia and sevoflurane-based inhalation anesthesia. For patients undergoing metabolic bariatric surgery, there is limited evaluation data concerning the overall recovery effect, and the conclusions are varied. This study aims to explore the difference between intravenous anesthesia and inhalation anesthesia in terms of the quality of early postoperative recovery in patients who undergo bariatric surgery. A total of 104 patients with obesity who underwent elective laparoscopic sleeve gastroplasty were randomly assigned two groups: the propofol (T) group and the sevoflurane (S) group. Five cases were excluded due to last-min changes in surgical plans, and finally 99 patients were included in the analysis (49 in Group S and 50 in Group P). In both groups, patients received propofol, remifentanil and rocuronium for induction. In Group P, anesthesia was maintained with intravenous propofol and remifentanil. In Group S, anesthesia was maintained with sevoflurane and remifentanil. The quality of recovery-40 (QoR-40) scale and the pain numerical rating scale (NRS), were used for evaluations before surgery and 24 and 48 h after surgery, and other relevant indicators were recorded. In results: compared with Group S, the QoR-40 score at 24 h in the Group P was significantly higher (161 and 150; P<0.001), indicating better recovery quality in the Group P than in the Group S. Among the five dimensions of the QoR-40, the Group P showed significantly better physical comfort, psychological support, and physical independence at 24 h postoperatively. No significant intergroup difference in QoR-40 scores was observed at 48 h postoperatively, and NRS scores were comparable between groups at both time points. The study results indicate that propofol intravenous anesthesia is associated with better recovery quality at 24 h after metabolic bariatric surgery, while the recovery difference between the two methods diminishes by 48 h.