The Effect of Propofol-Remifentanil and Isoflurane-Remifentanil Anaesthesia on Postoperative Quality of Recovery after Laparoscopic Cholecystectomy

Open Access

Abstract

Background: Anaesthesia is an essential component of modern surgery, enabling most surgical procedures through the induction and maintenance of unconsciousness using intravenous and inhalational agents. It is widely regarded as one of the most significant advances in medicine, and the choice of anaesthetic technique plays a crucial role in determining postoperative recovery quality and overall patient outcomes. Objective: The aim of the study was to compare the effects of propofol-remifentanil and isoflurane-remifentanil anaesthesia on postoperative quality of recovery after 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, from October 2024 to September 2025. Seventy-two patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were equally allocated to Group PR (propofol-remifentanil) and Group IR (isoflurane-remifentanil) to compare postoperative recovery, pain, haemodynamics, opioid use, and complications. Data were analyzed using SPSS version 29.0 with p < 0.05 considered significant. Results: The study included 72 patients (36 per group) undergoing laparoscopic cholecystectomy. Baseline characteristics were comparable (p > 0.05). Group PR showed significantly better QoR-15 scores at 12 and 24 hours (p < 0.01), shorter recovery room stay (p < 0.01), and lower post-induction blood pressure (p < 0.01), while heart rate remained similar. Group PR also had lower pain scores, reduced opioid requirement (27.78% vs. 77.77%), and lower opioid consumption (28.6 ± 12.3 vs. 46.9 ± 15.8 mg; p < 0.001). Nausea was higher in Group IR (30.5% vs. 8.3%; p = 0.03), with other complications comparable. Conclusion: Propofol-remifentanil anaesthesia provides superior postoperative recovery compared with isoflurane-remifentanil anaesthesia after laparoscopic cholecystectomy.