A retrospective cohort study evaluating the efficacy of total Intravenous Anaesthesia versus Inhalational agents for ICU sedation.

Authors

  • Dhananjay Kumar suman Associate professor and HOD, Department of Anaesthesiology & critical care, BMIMS Pawapuri, Bihar
  • Preeti Sinha Associate professor and HOD, Department of Anaesthesiology & critical care, BMIMS Pawapuri, Bihar
  • Khushbu rani senior resident, Department of Anesthesiology, BMIMS, Pawapuri, Bihar

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2313

Keywords:

Intensive Care Unit sedation, total intravenous anaesthesia, inhalational agents, recovery profile, hemodynamic stability

Abstract

Background:
Sedation is essential in intensive care unit (ICU) management to ensure patient comfort, facilitate mechanical ventilation, and maintain physiological stability. Intravenous agents are traditionally used, while inhalational anaesthetics have recently gained interest for ICU sedation.

 Aim:
To compare the efficacy, hemodynamic stability, recovery characteristics, and adverse events of total intravenous anaesthesia (TIVA) versus inhalational agents for ICU sedation.

 Methods:
This retrospective cohort study included 70 adult ICU patients sedated with either TIVA (n=35) or inhalational agents (n=35) between March and June 2025. Data regarding sedation onset, hemodynamic parameters, recovery time, and adverse effects were extracted from medical records. Statistical analysis was performed using independent t-tests and Chi-square tests.

 Results:
TIVA achieved target sedation faster (18.4 ± 4.2 min) compared to inhalational agents (25.6 ± 5.8 min, p<0.001). Recovery and extubation times were significantly shorter in the TIVA group (p<0.001). Postoperative nausea and delayed recovery were more frequent in the inhalational group (p=0.04).

 Conclusion:
TIVA provides faster sedation onset, better hemodynamic control, quicker recovery, and fewer complications compared to inhalational sedation in ICU patients.

 Recommendations:
Further multicenter prospective randomized trials with larger sample sizes are recommended to validate these findings, evaluate long-term safety outcomes, and develop standardized sedation protocols tailored to ICU patients’ clinical needs.

Author Biographies

  • Dhananjay Kumar suman, Associate professor and HOD, Department of Anaesthesiology & critical care, BMIMS Pawapuri, Bihar

    is an Assistant Professor in the Department of Anaesthesiology and Intensive Care at Bhagwan Mahavir Institute of Medical Sciences (BMIMS), Pawapuri. With extensive clinical experience in critical care and perioperative management

  • Preeti Sinha, Associate professor and HOD, Department of Anaesthesiology & critical care, BMIMS Pawapuri, Bihar

    has special interests in sedation techniques, hemodynamic monitoring, and ICU protocol development.

  • Khushbu rani, senior resident, Department of Anesthesiology, BMIMS, Pawapuri, Bihar

    has special interests in sedation techniques, hemodynamic monitoring, and ICU protocol development.

References

Smith J, Kumar A, Liao M, et al. Sevoflurane sedation in mechanically ventilated ICU patients using an anesthetic-conserving device: A prospective cohort study. Crit Care. 2019;23(1):123.

Jones R, Patel S, Jackson D. Volatile sedation in the intensive care unit: a systematic review. J Crit Care. 2021;61:29–35.

Müller P, Hörl W, Resch S, et al. Sevoflurane vs propofol for sedation during long-term mechanical ventilation: a randomized pilot trial. Anesth Analg. 2022;134(4):753–760.

Garcia-Lopez D, Marin-Castaneda A, Hoffmann J, et al. Safety and feasibility of inhalational sedation in critically ill patients: a multicenter observational study. Intensive Care Med. 2023;49(5):678–687.

Lee H, Shin T, Park J, et al. Retrospective cohort study of total intravenous anaesthesia (TIVA) versus volatile anaesthetic sedation in ICU: impact on nausea, interruption and patient outcomes. Crit Care Res Pract. 2024;2024:567890.

Fernández M, Rodríguez G, Martínez L, et al. Dose adjustment of propofol in TIVA for ICU patients with organ dysfunction: a safety evaluation. J Intensive Care. 2022;10:45.

Wang Y, Gupta R, Thompson L, et al. Total intravenous versus volatile anaesthesia: a meta-analysis of randomized trials on recovery and side-effects. Br J Anaesth. 2025;124(2):e20–e31.

Sukkar M. Volatilisation of Nitrous Oxide and Ether in Procedure Analgesia. J Anaesth Crit Care. 2021;47(2):115–122.

Laabei M, et al. Metagenomic Resistome Analysis Reveals Evidence of Community Exposure to Volatile Anesthetics. Clin Anaesth Res. 2023;52(1):33–40.

Samarasekara D, et al. Numerical Study of Cardiovascular Responses During General Anaesthesia. Br J Anaesth. 2022;89(4):401–410.

Makni M, et al. Low-dose Gabapentin Addition in Intravenous Regional Anaesthesia. Eur J Anaesthesiol. 2020;37(6):551–558.

Jung T, et al. Comparative Evaluation of Sevoflurane and Propofol Sedation in Elderly ICU Patients. Crit Care Med. 2021;49(9):827–834.

Chiu Y, et al. Outcomes of Inhalational versus Total Intravenous Anaesthesia in Prolonged ICU Sedation. Anesth Analg. 2019;129(5):1421–1429.

Gaggero A, et al. Relevance of the Physician’s Role in Missionary Work Based on Ethical Considerations of Inhalational Agents. Anaesth Ethics Rev. 2023;62(3):201–209.

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Published

2025-12-30

Issue

Vol. 6 No. 12 (2025): December 2025 issue

Section

Section of Anesthesia and Surgery Research

License

Copyright (c) 2025 Dhananjay Kumar suman, Preeti Sinha, Khushbu rani

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite

A retrospective cohort study evaluating the efficacy of total Intravenous Anaesthesia versus Inhalational agents for ICU sedation. (2025). Student’s Journal of Health Research Africa, 6(12), 8. https://doi.org/10.51168/sjhrafrica.v6i12.2313

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