Total Intravenous Anesthesia (TIVA) Versus Inhalational Anesthesia at The End of Laparoscopic Obstetric Surgery Regarding Postoperative Nausea and Vomiting

NCT07270289 | Not Yet Recruiting DMC

• 1 other identifier: tiva vs inhala anesth in ponv
• Study Type: interventional
• Target: 98
• Locations: 0 countries
• Sites: N/A

Brief Summary

Postoperative nausea and vomiting (PONV) remain among the most common and distressing complications after general anaesthesia, with important consequences for patient comfort, satisfaction, recovery trajectories, and length of stay following surgery. The incidence of PONV is especially high after laparoscopic and gynaecological procedures due to patient- and procedure-related risk factors, making effective prevention and management a priority in perioperative care \[5,8\]. Anaesthetic technique is a recognized, modifiable determinant of PONV. Numerous clinical trials and randomized studies have demonstrated that the choice between propofol-based total intravenous anaesthesia (TIVA) and volatile inhalational maintenance can materially influence PONV incidence. Propofol-based TIVA has been repeatedly associated with lower rates of early and overall PONV compared with volatile agents in diverse surgical populations, supporting its role as an antiemetic strategy in addition to pharmacologic prophylaxis \[1,2,4,9\]. Trials specifically conducted in gynaecological and laparoscopic surgical populations report consistent reductions in nausea and vomiting with propofol maintenance compared with isoflurane or other volatile agents. These procedure-specific data are directly relevant to studies in gynecological laparoscopy, where baseline PONV risk is elevated and where anesthetic technique may yield a clinically meaningful reduction in patient morbidity \[5,8,9\]. Meta-analyses and systematic reviews pooling randomized controlled trials provide higher-level evidence that TIVA reduces the relative risk of PONV compared with volatile anaesthesia. Trial-sequential and pooled analyses estimate a clinically important risk reduction favoring TIVA, although effect sizes vary with study populations, prophylactic antiemetic regimens, and outcome time windows; these syntheses underpin the rationale for a targeted randomized comparison in the gynecological laparoscopic setting \[2,4,10\].

Conditions

Laparoscopic Obstetric Surgery

Outcome Measures

Primary Outcomes (2)

• Incidence of post operative neasea

  Any episode of nausea (NRS ≥ 4/10 or requiring treatment)

  24 hours

• incidance of postoperative vomting

  any episode of vomiting/retching recorded at 0-2, 2-6, and 6-24 h; need for rescue antiemetic

  24 hours

Study Arms (2)

Group A

ACTIVE COMPARATOR

patients will be offed from inhalational anesthesia and Switched to propofol TIVA for the final 10 minutes of surgery

Procedure: inhalational anaesthesia; Procedure: total intravenous anesthesia (TIVA)

Group B

ACTIVE COMPARATOR

patients will be Continued on inhalational anaesthesia (sevoflurane or isoflurane per protocol)during the same final phase through extubation.

Procedure: inhalational anaesthesia

Interventions

inhalational anaesthesia PROCEDURE

patients will be offed from inhalational anesthesia

Group A; Group B

total intravenous anesthesia (TIVA) PROCEDURE

patients will be Switched Total Intravenous Anesthesia (TIVA)

Group A

Eligibility Criteria

• Age: 18 Years - 50 Years
• Gender Eligibility Details: female only
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Female, age 18-50 years.
• Elective laparoscopic procedure under general anaesthesia with endotracheal intubation.
• Expected surgical duration ≥ 30 minutes. -.Ability to consent and complete questionnaires

You may not qualify if:

• Pregnancy or lactation.
• BMI ≥ 40 kg/m²; severe cardiopulmonary disease; hepatic/renal failure.
• History of malignant hyperthermia or contraindication to study drugs.
• Known allergy to propofol, , , sevoflurane/desflurane.

Sponsors & Collaborators

• Assiut University: lead

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident doctor at Anesthesia, Intensive Care and Pain Management

Study Record Dates

• First Submitted: November 26, 2025
• First Posted: December 8, 2025
• Study Start: December 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2027
• Last Updated: December 8, 2025

Record last verified: 2025-11