Hemodynamic Profile and Postoperative Pain Following Propofol-Remifentanil and Isoflurane-Remifentanil Anaesthesia in Laparoscopic Cholecystectomy

Open Access

Abstract

Background: Laparoscopic cholecystectomy is the standard approach for cholelithiasis, offering reduced postoperative pain and faster recovery compared to open surgery. General anaesthesia is routinely used, and the choice of technique plays a key role in ensuring haemodynamic stability and optimal perioperative outcomes. Objective: The aim of the study was to compare the hemodynamic profile and postoperative pain outcomes between propofol-remifentanil and isoflurane-remifentanil anesthesia in patients undergoing laparoscopic cholecystectomy. Methods & Materials: This quasi-experimental study was conducted in the operation theatre of the Department of General Surgery, Bangladesh Medical University, Dhaka, Bangladesh (October 2024-September 2025). Seventy-two patients undergoing elective laparoscopic cholecystectomy were purposively sampled and equally allocated to Group PR (propofol-remifentanil) and Group IR (isoflurane-remifentanil) to compare perioperative haemodynamic parameters and postoperative pain outcomes. Standardized anaesthetic protocols were applied, and data were analysed using SPSS version 29.0. Results: A total of 72 patients (36 per group) were included, with comparable baseline demographic and clinical characteristics between the PR and IR groups (p > 0.05). Heart rate remained similar throughout the perioperative period, while systolic and diastolic blood pressures were significantly lower in the PR group (p < 0.01). Postoperative pain was significantly reduced in the PR group at early time points, and opioid requirement was markedly lower (27.8% vs. 77.8%; 28.6 ± 12.3 vs. 46.9 ± 15.8 mg; p < 0.001), with differences resolving by 24 hours. Conclusion: Propofol-remifentanil anesthesia offers better hemodynamic stability and postoperative pain control than isoflurane-remifentanil anesthesia in laparoscopic cholecystectomy.