Comparison of the Time to Orientation between Combining Propofol with Sevoflurane or Sevoflurane in Patients Undergoing Endoscopic Trans-Nasal Surgery: A Randomized Controlled Trial

Background: This study investigates whether combining propofol and sevoflurane for anesthesia maintenance results in faster emergence compared to sevoflurane alone in patients undergoing endoscopic trans-nasal surgery. Methods: Thirty-eight patients were randomized to receive either sevoflurane alone (Group S, n = 19) or propofol plus sevoflurane (Group PS, n = 19) targeting a BIS range of 40 - 60. The primary outcome was time to orientation. Secondary outcomes included time to spontaneous ventilation, eye-opening to sound, extubation, hemodynamics, agitation, coughing, analgesic needs, and PONV. Results: The median time to orientation was significantly longer in Group PS (12 minutes, IQR 6-16) compared to Group S (6 minutes, IQR 5-12) (P Conclusion: Using BIS-targeted anesthesia, combining propofol with sevoflurane resulted in a longer time to orientation than sevoflurane alone in patients undergoing endoscopic trans-nasal surgery, particularly when anesthesia exceeded 120 minutes.