| Purpose: This retrospective cohort study aimed to investigate the effects of propofol combined with sevoflurane on emergence agitation(EA)and recovery profiles in adults receiving resection of colorectal cancer,compared with propofol anesthesia maintenance.Methods: We collected data of adult patients who received resection of colorectal cancer between January and December 2016 in our hospital.According to whether anesthesia maintenance was combined with sevoflurane,they were divided into propofolsevoflurane maintenance group and propofol maintenance group.The main outcome was the incidence of EA in the post-anesthesia care unit(PACU).The secondary outcomes included time to extubation,sedation therapy in PACU,duration of PACU stay,postoperative pain numerical rating scale(NRS)≥4 in PACU,intraoperative hypotension and bradycardia,recovery outcomes within 24 hours in the ward(hypotension,bradycardia,nausea and vomiting,use of antiemetics,pain NRS≥4,use of analgesics,and hypoxemia),and length of hospital stay.Univariate and multivariate regression analyses were used to analyze data.Results: Among 792 patients,186 received propofol-sevoflurane anesthesia maintenance,606 received propofol anesthesia maintenance.Compared with propofol maintenance,combination of propofol and sevoflurane was associated with a higher incidence of EA(28.5% vs 15.7%;adjusted OR,2.25;95% CI,1.49-3.42;P<0.001)and sedation therapy(26.9% vs 15.7%;adjusted OR,2.19;95% CI,1.43-3.37;P<0.001)in the PACU,prolonged time to extubation(49 min vs 38 min;β,8.36;SE,3.35;P=0.013)and duration of PACU stay(90 min vs 74 min;β,13.17;SE,4.30;P=0.002).Moreover,propofol-sevoflurane maintenance was associated with lower incidences of intraoperative hypotension(18.3% vs 27.2%;adjusted OR,0.64;95% CI,0.42-0.99;P=0.043)and hypotension occurring within postoperative 24 hours in the ward(7.5% vs 13.7%;adjusted OR,0.50;95% CI,0.27-0.94;P=0.030).No significant differences were observed in other recovery outcomes.Conclusion: This retrospective study suggested that,in adults undergoing resection of colorectal cancer,compared with propofol maintenance,propofol-sevoflurane anesthesia maintenance was associated with a higher incidence of EA in the PACU,prolonged time to extubation and duration of PACU stay,and a lower incidence of hypotension. |
