Comparison of sevoflurane and total intravenous anaesthesia for daycase urological surgery

Target-controlled total intravenous anaesthesia using propofol and remifentanil was compared with inhalational anaesthesia using sevoflurane and alfentanil in patients undergoing daycase urological surgery. Seventy-one patients were randomly allocated to receive either a target-controlled infusion of an admixture of propofol and remifentanil (125 microg of remifentanil added to 500 mg of propofol), or inhalational anaesthesia with sevoflurane and intra-operative alfentanil. There was no difference in time to fitness for discharge, time to fitness for transfer from primary to secondary recovery, time to first oral intake or adverse anaesthetic induction occurrences. Patient satisfaction assessed at 24 h post-discharge was high in both groups with no significant difference between groups. The incidence of nausea and vomiting was low in both groups. We conclude that, for ultra-short stay surgery, both the techniques we describe offer satisfactory anaesthesia with very early resumption of street fitness.