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

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].

Study Overview

• Status: Not yet recruiting
• Conditions: Laparoscopic Obstetric Surgery
• Intervention / Treatment: Procedure: inhalational anaesthesia; Procedure: total intravenous anesthesia (TIVA)

• Study Type: Interventional
• Enrollment (Estimated): 98
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 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

Exclusion Criteria:

• 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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A; patients will be offed from inhalational anesthesia and Switched to propofol TIVA for the final 10 minutes of surgery	Procedure: inhalational anaesthesia; patients will be offed from inhalational anesthesia; Procedure: total intravenous anesthesia (TIVA); patients will be Switched Total Intravenous Anesthesia (TIVA)
Active Comparator: Group B; patients will be Continued on inhalational anaesthesia (sevoflurane or isoflurane per protocol)during the same final phase through extubation.	Procedure: inhalational anaesthesia; patients will be offed from inhalational anesthesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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

Collaborators and Investigators

• Sponsor: Assiut University

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: November 26, 2025
• First Submitted That Met QC Criteria: November 26, 2025
• First Posted (Actual): December 8, 2025

Study Record Updates

• Last Update Posted (Actual): December 8, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: tiva vs inhala anesth in ponv

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No