Comparison of inhalational anesthesia (Sevoflurane) and total intravenous anesthesia with propofol, dexmedetomidine on postoperative nausea and vomiting and postoperative recovery parameters in laparoscopic surgery - A prospective randomized controlled trial.

Postoperative nausea and vomiting are common and problematic after general anesthesia in laparoscopic surgery. its incidence as high as 60-80% in high risk patients. Use of opioids and volatile anesthetic agents during maintenance of anesthesia increase the incidence of postoperative nausea and vomiting. So use of alternative agents like propofol and dexmedetomidine during maintenance of anesthesia is effective for prevention of postoperative nausea and vomiting. Postoperative parameters are also variable by using of two different methods during maintenance of anesthesia. So we designed a study to compare the effectiveness of inhalational (sevoflurane) and total intravenous anesthesia with propofol and dexmedetomidine for reduction of postoperative nausea and vomiting and variability in postoperative recovery parameters. All selected patients will be randomized in to two groups (40 patients in each group) depending on the agents used during maintenance of anesthesia. Induction of anesthesia is similar in both groups.

Group A - Anesthesia will be maintained with O2:N2O; 40:60 and sevoflurane to achieve a target BIS between 40 to 60.

Group B- Dexmedetomidine loading dose 1mcg/kg over 15 minutes duration,  5 minutes before induction of anesthesia. Anesthesia will be maintained with dexmedetomidine 0.5mcg/kg/hr and titrated dose of propofol to achieve a target BIS between 40 to 60.

Primary outcome - postoperative nausea and vomiting in first 24 hour postoperative period

Secondary outcome - Postoperative recovery parameter (extubation time, respond to verbal command and orientation time in minutes)

Statistical analysis will be done after completion of study.